What Is Psychological Hope, Really?

When a psychologist talks to you about hope, they generally are not referring to blind optimism or wishful thinking. More often, they speak of hope as a structured mental concept that is essential for motivation and growth. 

This concept shapes how you respond to challenges, think about the future, and also stay engaged even when things become difficult. Psychological hope may be quiet, but it plays a powerful role in the way people navigate setbacks, stress, and recovery. 

Hope Is More Than Positive Thinking

Many people think hope simply means “staying positive,” but it’s much more than that. In psychology, hope is built on two key components: agency and pathways.

Agency is the belief that you can move forward. It reflects the idea that your actions matter and can create real change. Pathways refer to your ability to find ways to reach your goals, even when challenges or setbacks arise.

Together, these elements create a mindset that is both motivated and grounded in reality. Hope is not about pretending everything will work out or ignoring what is difficult. It is about believing there is a way forward and trusting that you can take the steps to find it.

Why Hope Matters Across Many Mental Health Struggles

One of the key reasons why it’s important to be hopeful is that hope is considered transdiagnostic, meaning it influences a variety of mental health issues and not just a single diagnosis. 

Whether you are dealing with depression, chronic stress, or anxiety, hope can influence how you cope or respond. 

Lower levels of hope can make it difficult for you to manage your emotions, stay motivated, and maintain a sense of connection. On the other hand, higher levels of hope are connected to better emotional regulation, stronger resilience, and a greater ability to persist through difficulties. 

Related: Can Hope Heal Chronic Pain? What Science Says

Related: 10 Signs You May Have Adult ADD

Living With Undiagnosed ADHD

After recognizing himself in the symptoms of ADHD, John decided to take the next step and seek help. Like many adults, he turned to a traditional healthcare provider, hoping for clarity and direction.

What he experienced instead was a familiar path for many people struggling with attention and focus issues. The evaluation focused primarily on symptoms. He was given a basic diagnostic exam and quickly offered medication as the primary solution.

“They basically gave me a computer test and wanted to offer some stimulants,” John recounts. He thought, “If that’s the only thing that can help me, I didn’t feel comfortable doing that.” 

Without a deeper understanding of what was happening in his brain, John didn’t yet know that there were other options available to him. And like many people in similar situations, John stepped away from the process altogether.

Over time, the challenges continued. As a teacher, he noticed it was taking him much longer than others to complete everyday tasks like grading papers. Staying organized felt nearly impossible, and small responsibilities began to pile up.

“It was taking me longer to do my work… my lack of organization, not picking up things,” he says. “It’s one of those things where it’s like I’m not purposely doing it.” 

Without answers, it was easy to internalize these challenges as personal shortcomings rather than signs of something in his brain. “It was just kind of my personality trait at this point,” John explains. 

But the impact didn’t stop at work. Over time, these patterns began to affect his relationship as well. As frustration grew, he and his wife turned to marriage counseling, searching for solutions without yet realizing the root cause.

What Is Negativity Bias?

Negativity bias is your brain’s tendency to focus more on the negative than the positive. 

Negativity Bias Means the Brain Gives More Weight to Negative Information

Negative bias means the brain prioritizes potential threats, problems, and mistakes over neutral or good experiences.

This means you’re more likely to notice criticism than praise, remember what went wrong instead of what went right, and interpret unclear situations in a negative way. Even when something is neutral, your brain may fill in the gaps with worst-case assumptions.

Negativity Bias Is More Than “Being Pessimistic”

Negativity bias isn’t just about having a gloomy outlook. It can shape how your brain processes the world on multiple levels.

It influences:

• Attention – what you notice first
• Emotion – how strongly you react
• Memory – what you remember most
• Decision-making – the risks you focus on
• Social interactions – how you interpret other people’s behavior

Over time, this bias can create a pattern where negative experiences feel more intense, more frequent, and more important than they actually are.

Why It Shows Up So Often in Anxiety Disorders

Negativity bias is especially common in people with anxiety. In fact, research points to it as a core symptom of anxiety. When your brain is wired to scan for danger, it becomes hyper-focused on anything that could go wrong.

This can lead to a constant loop of worry, overthinking, and emotional reactivity. Small concerns feel bigger, and uncertainty feels threatening.

Over time, this pattern can disrupt both emotional balance and clear thinking, making it harder to regulate your mood, stay focused, or feel resilient under stress.

Related: Why Are We So Negative?

An Early Life of Substance Abuse: Alcohol, Cocaine, Marijuana

Zach Skow’s struggles with alcohol and drug addiction began early. By the age of 10, he had already started drinking, sneaking wine and vodka from cabinets at home. Not long after, drugs entered the picture. He began using marijuana at 13 and later discovered cocaine at 16.

Reflecting back, Zach has said that for as long as he can remember, he felt addicted to drugs and alcohol. He did not feel normal. He felt uncomfortable in his own skin and found it difficult to handle pressure or stress. Alcohol, he recalls, helped him cope with those feelings and made it easier to function in the world.

But what he did not understand at the time was that his brain was playing a powerful role in driving these behaviors.

Substances like alcohol and drugs trigger the release of dopamine, the brain’s “feel-good” chemical. For someone already struggling with emotional discomfort, this temporary relief can quickly become reinforcing. Over time, the brain begins to crave that escape, making it harder to stop the cycle.

What started as a way to self-soothe gradually became a pattern that would shape the course of his life, long before he had the insight or support to understand what was really happening in his brain.

Video: “If I Didn’t Have Those Dogs During That Experience I Would Have Killed Myself”: Zach Skow’s Story

Liver Failure, Sobriety, and Working with Dogs

Years of an out-of-control alcohol use disorder and drug abuse eventually brought Zach to death’s door.

In 2007, his body began to shut down. He remembers turning yellow, a visible sign of severe liver damage. What he would later learn was ascites, a serious condition linked to liver failure, had taken hold. The situation was life-threatening, and it forced a moment of reckoning.

At the same time, Zach committed to sobriety.

The early days were anything but easy. Withdrawal was intense, both physically and emotionally. But in the middle of that struggle, something unexpected began to change the trajectory of his life.

He started working with dogs.

What began as fostering quickly turned into something more. He brought in one dog after another, volunteered with animal rescue organizations in Tehachapi, CA, and immersed himself in caring for animals that, like him, needed a second chance.

He also began walking regularly and made significant changes to what he put into his body.

At the time, these activities were pursued simply as a way to survive. Zach did not know that he was intuitively drawn to what was helping him heal. 

Indeed, animal therapy is recognized in research as a positive adjunctive therapy in substance use disorder recovery. Additionally, research has found that the positive effects of exercise can be an effective intervention in addiction recovery. 

He also did not realize that these acts of self-preservation would eventually become his life’s work and purpose.

Looking back, Zach has been candid about just how critical that connection was, saying, “If I didn’t have my dogs for that experience, I would have killed myself.” They gave him a reason to keep going when everything else felt uncertain.

Related: Does Alcohol Kill Brain Cells? What Science Really Says

Discovering Amen Clinics and the Comprehensive Evaluation for Addiction 

Zach’s journey took another pivotal turn when, as he describes it, “very miraculously,” someone from Amen Clinics reached out after hearing his story on a podcast and seeing his work online.

“That led me into the process of understanding what status my brain is in,” Zach recalls.

Working with Amen Clinics’ psychiatrist, Dr. Steven Storage, Zach underwent a brain SPECT scan and a comprehensive evaluation. 

From the start, he felt supported. “Dr. Storage is just the best. I love that guy,” he says. 

But the results were not easy to hear. “We walked through them, and they were difficult,” Zach explains. “I was essentially told that I had degrees of brain damage that we can work on.” 

It was a sobering moment, no pun intended. Years of substance use had taken a measurable toll. The effects of alcohol on the brain over the course of years were visible. But instead of leaving him discouraged, the experience gave him understanding.

“I’ve damaged myself over the long haul. I’ve got to repair myself kind of over the long haul,” he says. “So I’m optimistic… and now I have a much better understanding of what’s going on with me.”

Even more validating was seeing the science align with his experience. “What Dr. Storage thought we might see in my scans was exactly what happened.”

For Zach, this was more than a diagnosis. It was confirmation, clarity, and the beginning of a new path forward grounded in brain health and real solutions.

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How Is Depression Traditionally Diagnosed?

Major depressive disorder is traditionally identified through:

• Clinical interviews
• Symptom checklists (based on the Diagnostic and Statistical Manual of Mental Disorder, known as the DSM-5-TR)
• Patient history
• Functional impairment (reported effects on daily activities and relationships)

While these are useful steps to take, the symptoms of depression can overlap with other mental health conditions, making accurate diagnosis more difficult. And co-existing factors, including anxiety, trauma, or attention deficit hyperactivity disorder (ADHD), also called attention deficit disorder (ADD), can complicate accurate diagnosis further.

Related: What Doctors Can’t Tell You About Your Depression, Anxiety, or Anger

With traditional diagnosis, there is no biological testing, though numerous biological factors can contribute to depression. Without looking at the very organ affected, the brain, or having an accurate diagnosis, doctors often take a trial-and-error approach to treatment. Unfortunately, this can lead to delayed symptom relief, persistent adverse side effects, and patient discouragement. 

Can Brain SPECT Imaging Help Identify Depression?

SPECT is an acronym for single photon emission computed tomography. This type of imaging provides a functional brain scan, as opposed to structural imaging tools such as MRI or CT scans, which show the brain’s anatomy. 

As a state-of-the-art nuclear medicine study, SPECT measures blood flow and activity levels in different areas of the brain. This shows how the brain is working. It identifies areas of healthy activity, overactive activity, or underactive activity in different regions of the brain.

SPECT imaging does not diagnose depression on its own. But it can reveal brain activity patterns commonly associated with depressive symptoms. SPECT may also help differentiate depression from other conditions that are present.

SPECT therefore provides additional data beyond symptom reporting. With a clearer picture of the brain’s workings, SPECT imaging helps guide a more personalized understanding of what may be happening in the brain. This information then helps guide a more accurate diagnosis and targeted treatment.

What Brain Patterns Are Associated With Depression?

A variety of brain patterns are associated with depression:

• Decreased activity in the prefrontal cortex (PFC), the brain’s executive center (involved with tasks such as problem solving, planning, and judgment). This can affect mood regulation and motivation. Decreased activity in the PFC has also been associated with lack of forethought, poor judgment, and impulse control problems.
• Increased activity in the limbic system, the brain’s emotional center. This region enables humans to experience and express emotions and helps regulate emotional intensity. 
• Overactivity in certain brain regions linked to rumination. For example, excessive activity in the brain’s anterior cingulate gyrus, basal ganglia, and/or the deep limbic system is associated with trouble shifting attention from negative thoughts or behaviors.
• Low overall brain activity (present in some cases of depression). 

Mental health conditions, including depression, are complex. But research and imaging studies suggest associations between certain symptoms and brain patterns. SPECT helps provide a deeper understanding of depression when used alongside traditional diagnosis methods.

Depression Is Not One Condition

Not all depression looks the same. Different individuals may have:

• Low activity patterns, associated with low motivation or fatigue
• Overactive patterns, linked with rumination and anxiety
• Mixed or complex presentations, such as mixed anxiety/depression (depression and anxiety occur together 75 percent of the time)

With a database of nearly 300,000 SPECT scans and having treated more than 100,000 patients over decades, our work at Amen Clinics has revealed that depression is not one thing. In fact, our clinicians have identified seven types of depression and anxiety, each with a distinct pattern of blood flow and brain activity:

1. Pure Anxiety often results from too much activity in the basal ganglia, setting one’s “idle speed” on overdrive. 
2. Pure Depression often occurs with excessive activity in the deep limbic system. This type may experience symptoms from chronic mild sadness (dysthymia) to crippling major depression.
3. Mixed Anxiety/Depression involves a combination of both Pure Anxiety symptoms and Pure Depression symptoms. This type shows excessive activity in the brain’s basal ganglia and the deep limbic system.
4. Over-Focused Anxiety/Depression involves excessive activity in the brain’s anterior cingulate gyrus, basal ganglia, and/or the deep limbic system. This type may have trouble shifting attention and often gets locked into anxious and/or negative thoughts or behaviors.
5. Temporal Lobe Anxiety/Depression is related to too little or too much activity in the temporal lobes (involved in moods, emotions, and memory). There can also be overactivity in the basal ganglia and/or deep limbic system. As a result, this type may experience irritability, rage, or confusion.
6. Cyclic Anxiety/Depression is associated with extremely high activity in the brain’s basal ganglia and/or deep limbic system. This activity can hijack the brain for periods of time in a cyclical pattern.
7. Unfocused Anxiety/Depression types may show low activity in the PFC, in addition to high activity in the basal ganglia and/or deep limbic system. Unfocused Anxiety/Depression is often misdiagnosed as ADD/ADHD because of its similar symptoms. Brain imaging allows for a more accurate diagnosis.

With seven types of depression, each having their own presentation and symptoms, a one-size-fits-all treatment often does not work. The treatment protocol for one type might make another type’s symptoms worsen. Using brain SPECT imaging helps create a more effective treatment plan because it is customized to treat the individual’s type of depression.

Video: Seven Types of Anxiety & Depression

Why Symptoms Alone May Not Tell the Whole Story

Depression symptoms can overlap with other conditions. For example, the same symptoms of depression could also be the symptoms noted for any of the following conditions: 

• Anxiety
• Trauma
• Hormonal imbalance
• Sleep disorders
• Thyroid dysfunction
• Nutritional deficiencies

Therefore, symptoms alone may not tell the whole story. Ruling out medical causes is essential before diagnosing major depressive disorder.

How Amen Clinics Uses SPECT Imaging in Depression Evaluation

With our brain health-first approach, Amen Clinics uses SPECT imaging as an integral part of a comprehensive evaluation. 

SPECT is combined with diagnostic tools such as:

• A detailed clinical history
• Neuropsychological testing and assessments 
• Lab tests, if needed

This collection of data, including the SPECT scan, helps our clinicians gain a clear understanding of what is really happening in the brain. If you have depression, they will typically be able to identify which subtype you have, plus any co-occurring conditions. 

Then, using precision medicine, they can design a treatment plan tailored to address any identified brain dysfunction, as well as boost overall brain and body health.   

A clinician reviews your SPECT scan and personalized treatment plan with you in detail.

SPECT scans also help clients and their loved ones understand that the symptoms of depression are not flaws, character defects, or personal weaknesses. Seeing the brain function issues on the brain scan depersonalizes depression. Knowing that this condition is rooted in brain function helps reduce shame and blame.

Moreover, this kind of scientific and compassionate understanding increases the motivation to make meaningful lifestyle changes. At follow-up appointments, the clinician and client can track results over time.

A Whole-Body Approach to Treating Depression

The brain-body connection is crucial in treating any mental health condition. Factors such as diet, physical activity, and sleep all significantly impact mental well-being.

Therefore, holistic psychiatry as practiced at Amen Clinics may include:

• Nutrition
• Supplements
• Sleep optimization
• Exercise
• Therapy
• Medication when appropriate

This whole-body approach to holistic psychiatry offers many natural ways to treat mental health conditions, including depression. But what works for one type of depression may not work for another. That’s why treatment is always personalized to the needs of the individual. 

Related: 9 Natural Ways to Help Depression

How Brain Imaging Can Support Personalized Treatment

Brain SPECT imaging offers numerous benefits for clinicians and their clients. This cutting-edge diagnostic tool:

• Helps identify the underlying brain patterns behind symptoms
• Guides treatment selection
• May reduce a trial-and-error approach to treatment

Individuals are different, and each person’s depression symptoms are unique. Therefore, treatment should be individualized and brain-based.

What Is Fibermaxxing?

As the name suggests, fibermaxxing is a dietary trend focused on significantly increasing daily fiber intake to support digestion, metabolic health, brain and mental health, and overall well-being.

The trend emphasizes increasing fiber intake through whole foods such as vegetables, fruits, seeds, legumes, and whole grains rather than relying on supplements. By prioritizing naturally high-fiber ingredients, this approach can help nourish a diverse gut microbiome while promoting satiety and supporting overall health.

The gut microbiome is a vast community of trillions of microorganisms in your digestive tract, including bacteria, viruses, fungi, and other microbes, that function together as a complex ecosystem. Fiber plays a critical role in maintaining a healthy balance within this system by nourishing beneficial bacteria. As a result, increasing your fiber intake is one of the most effective ways to support gut health.

Those who follow fibermaxxing often aim for higher-than-recommended amounts by intentionally adding fiber-rich foods to every meal or snack. Increasing fiber intake is usually positive, but it can become a liability when individuals consume too much.

The recommended daily intake of fiber is 25 grams per day for women and 38 grams per day for men. 

While there is no strict upper limit for dietary fiber, consuming more than 60 grams per day is generally considered too much for most people and can cause digestive distress. Even daily intake above 40 grams can cause symptoms in some individuals, especially if intake was increased quickly. Symptoms may include gas, bloating, constipation, or diarrhea. 

It is important to approach fibermaxxing with balance. Sustainable, steady changes are far more beneficial than extreme increases in fiber intake.

Why Journaling Can Support Mental Health

The brain has a tendency to replay worries on a loop. Psychologists call this rumination, a pattern that can intensify anxiety and depression. A 2022 literature review study on expressive writing found that structured writing exercises can help reduce rumination and support more effective processing of stressful experiences.

Writing things down helps slow those thoughts. Putting feelings into words also creates distance. Instead of being caught in an emotional spiral, you can get outside of it, gaining perspective. 

If you struggle with negative thoughts, it will also allow you to clearly examine a persistent negative thought and ask if it is really true. So often, our thoughts lie to us. When you question them, it helps reduce their negative influence. 

Journaling allows the brain to organize experiences into a clearer, more accurate narrative, making stressful events easier to understand. Research suggests that putting emotions into words supports cognitive processing and helps create meaning.

Journaling for mental health works best when it’s treated as a personal practice, not a task to get “right.” Some entries will feel insightful. Others may feel repetitive or incomplete. Both are part of the process. The real benefit comes from showing up and allowing your thoughts to unfold over time.

Related: How to Take Charge of Your Mental Health Journey

How to Start a Journal for Mental Health

Starting something new, especially something so personal, can feel awkward at first. If you’re hesitating because you’re worried about doing it wrong or that you won’t know what to write. That’s normal, too. But it doesn’t have to be scary. 

Instead of thinking about journaling as a creative project, try reframing it as a personal health habit like stretching or taking a walk. It’s simply a space where you can check in with yourself. Here’s how you can start:

Step 1) Choose a Format That Feels Comfortable

There’s no correct journaling format. What matters most is choosing a method that feels natural and private.

Notebook Journaling

Many people prefer a traditional notebook because writing by hand slows thinking down and encourages reflection. It can also help you feel grounded in the present, which is particularly beneficial as part of a morning or nightly ritual. Research shows that handwritten expressive writing exercises can improve emotional processing and reduce psychological stress in some participants.  

Benefits:

• Encourages deeper reflection
• No digital distractions
• Tangible record of personal growth

Considerations:

• Privacy concerns if others might read it
• Less convenient when traveling

Notes App or Digital Journal

Typing into a phone or computer works well for people who think quickly or prefer convenience. Just keep in mind that screens are social spaces by design. A 2022 study shows how digital devices interrupt attention and cognitive focus, so be aware that there is a greater potential for distraction if you are using one. 

Benefits

• Easy to access anytime
• Password protection available
• Faster for longer entries

Considerations:

• Screens can introduce distractions
• Some people feel less emotionally connected while typing

Guided Journals

Guided journals provide prompts or structured reflection questions. According to a 2018 study, structured writing prompts can help you explore emotions more effectively than completely unstructured writing, especially for beginners. 

Benefits:

• Helpful if you struggle to start
• Encourages deeper reflection on different topics

Considerations:

• Less flexibility in writing flow
• May feel restrictive for individuals more experienced with journaling 

Ultimately, the best format is the one you’ll actually use and enjoy doing. Try them all to see which one feels most natural and comfortable. Whatever you choose, make it a habit you return to consistently.

Decide When and How Often You’ll Write

Consistency matters more than the duration of your journaling session. It doesn’t require long sessions to be meaningful. A 2021 expressive writing study used sessions lasting about 15 to 20 minutes over several consecutive days, suggesting that relatively brief writing periods can still support emotional processing and reflection.

For everyday journaling, even 5 to 10 minutes can be enough. Try choosing a simple time anchor, such as:

• After your morning coffee
• Before bedtime
• During a quiet moment after work

Think of it less as an assignment and more as a personal ritual where you pause during the day to give your thoughts room to breathe. If journaling every day feels like too much, do it every other day. If you miss a day, just pick up again as soon as you can. Consistency is the goal. 

Set One Simple Ground Rule

Some people abandon journaling because they feel pressure to write well. Framing it as simply writing words on the page, instead of trying to make it sound polished, can help. A 2022 systematic review found many types of journaling interventions were associated with improved mental health symptoms. Setting just one small rule can remove that mental pressure and give you the freedom to just start writing.  Here are some “rules’ that can free up the process: 

“I don’t edit myself.”
Embracing free-flow journaling encourages a meditative flow, where thoughts move more freely without constant self-monitoring.

“Spelling doesn’t matter.”
Journaling isn’t an essay or novel plan. Imperfect writing often reflects more honest thinking, so just be honest with yourself. You’ll know what you meant.

“This is just for me.”
Your journal is a private space for you. No audience, no expectations, and no grades. Being honest with yourself can be the hardest step, but it’s worth it.

These rules are there to help you turn journaling into a place of honest expression that helps you regulate your emotions and heal your mental health.

Video: This Is How Negative Thinking Impacts Your Brain 

How to Write a Journal for Mental Health

Once you’ve started journaling, the next challenge is pretty common.

What exactly do I write?

Many people open a notebook and suddenly feel like their thoughts are a blank slate. That’s normal, too. Writing about your mental health doesn’t require dramatic stories or deep insights. 

Research suggests that simply expressing thoughts and emotions through writing can support emotional processing over time. Often, the most helpful entries start with what’s happening right now.

Start With What’s Present

Instead of trying to analyze your entire life story, begin with simple observations of your daily life. Some research shows that focusing on the present moment is linked to lower levels of stress, anxiety, and depression.

You might start writing about:

• Current emotions – Are you feeling frustrated, tired, hopeful, or anxious?
• Physical sensations – Do you feel tension in your shoulders? Is your heart racing? Have you been fatigued lately?
• Moments that stuck with you today – Any funny moments? Did you have a bad day? Did you laugh or cry today?  

These details may seem small, but they create self-awareness. Over time, journaling can reveal the patterns in your stress, mood, and daily experiences.

Use Simple Prompts When You Feel Stuck

Prompts are most helpful when you feel stuck because they can gently guide your thoughts without forcing them. Try starting with phrases like these:

“Right now, I feel…”

Write whatever emotions or moods are present at that moment, even if they seem contradictory.

“Something that’s been weighing on me lately…”

This prompt can help you identify recurring concerns, unresolved thoughts, and previously unknown mental burdens.

“One thing I keep thinking about…”

Repeating thoughts often signal something important on your mind that you’re trying to process. Even a few sentences responding to these prompts can open the door to deeper reflection.

Let the Writing Be Messy

One of the most helpful mindset shifts is accepting that messy writing is normal and can be quite helpful to understanding how you think. Your journal might include a few:

• Repeated thoughts
• Half-formed ideas
• Sudden emotional shifts
• Suppressed moods

But that’s not a bad thing. This is just your natural rhythm of processing experiences. Your human brain rarely follows a perfect structure in how you think. Journaling just gives your thoughts space to unfold.

Mental Health Journaling Prompts You Can Reuse

If you’d like more structure while you’re learning how to journal for mental health, specific prompts in the form of questions can help guide self-reflection without overthinking it. The examples below help you emphasize awareness, emotional regulation, and balanced thinking.

Stress and Overwhelm

• What’s been taking the most mental energy from me lately?

• If I could remove one stressor today, what would it be?

• What situation feels hardest to navigate right now?

Mood Tracking

• What emotion showed up the most today?

• When did I feel most calm or relaxed?

• Did anything unexpectedly improve my mood?

Self-Reflection

• What lesson did today teach me?

• What do I need more of right now: rest, connection, boundaries?

• What thought pattern do I notice repeating?

Gratitude (Without Forcing Positivity)

• What smaller moment felt meaningful to me today?

• Who or what supported me best this week?

• What am I quietly thankful for right now?

Gratitude journaling doesn’t mean ignoring difficult emotions. You simply add balance by noticing supportive moments in order to see the full picture outside of yourself.  

Related: The 5-Minute Morning Routine to Boost Your Brain

Common Journaling Mistakes (and What to Do Instead)

Journaling is most helpful when it feels supportive rather than stressful. However, these common habits can make it feel like a chore. Here are a few ways to reframe things when you start feeling off-track.

Trying to “Fix” Feelings Instead of Describing Them

Most people start journaling and immediately try to solve their problems and figure out all of their emotions.  Instead, focus on describing what’s happening now. Understanding often comes with time.

Writing Only When Things Feel Bad

Journaling during difficult moments is helpful, but writing occasionally during calm periods provides balance. It also makes journaling feel less like an emergency tool and more like a supportive habit.

Stopping Because You Missed a Few Days

Everyone knows life gets busy. Missing a few days, or even weeks, doesn’t erase the value of journaling whenever you can. It’s as simple as returning to it when you’re ready. Your journal isn’t keeping a winning or losing score on how often you write, and you shouldn’t either.

When Journaling Isn’t Enough on Its Own

Learning how to journal for mental health can be a powerful self-reflection tool, but it isn’t a cure-all treatment.

If your emotions feel intense, persistent, or overwhelming, support from a qualified mental health professional can make a meaningful difference. Therapists, psychiatrists, and other mental health professionals are trained to help you navigate complex emotional experiences.

A 2019 study suggests that expressive writing may complement other therapeutic approaches. For example, writing interventions have been studied as supportive tools for people facing stressful medical diagnoses, showing improvements in emotional well-being and quality of life. 

Still, journaling works best as one tool among many. It can work especially well when combined with professional guidance. 

But you don’t need to feel like something is wrong with you to gain the benefit of writing to understand yourself more.

Making Journaling a Sustainable Habit

The easiest way to maintain journaling is to connect it to an existing routine. Attach it to something you already do. A 2024 systematic review found that attaching a new behavior to an existing routine is one of the most effective ways to make it stick. Here are a few examples to think about trying:

• Write for five minutes immediately upon waking
• Reflect briefly on your day before bedtime
• Journal after a daily walk when your head is clear

Over time, lowering your expectations can also help sustain the habit. Instead of writing long entries every day, allow your practice to evolve from short bursts like:

• Some days might include one sentence
• Other days might include several pages
• Occasionally you may skip writing altogether

Journaling works best when it adapts to your life, not the other way around.

WHAT IS COGNITIVE DECLINE?

Much more common among aging individuals is what is called cognitive decline. They experience some brain changes and cognitive deficits that occur as part of the aging process, but their ability to function in everyday life is not impaired.

Chiefly, researchers have found that brain aging impacts some cognitive abilities, such as processing speed and some memory functions, visuospatial, language, and executive function abilities.

Medical research has identified the following features as characteristic of normal cognitive aging:

• Having Memory Lapses—For example, you might occasionally misplace things but can find them after retracing your steps.
• Being Forgetful—For instance, you might forget an appointment or name, but you can recall them at a later time.
• Ability to Maintain Daily Functions—As mentioned, these cognitive changes do not significantly impact your ability to do your day-to-day activities.

Many health professionals refer to this as “normal cognitive decline.”

However, Dr. Daniel Amen and the brain health specialists at Amen Clinics have found that cognitive decline may be common, but it is not normal. In fact, the brain-imaging work at Amen Clinics shows that age-related deficits can be reduced with lifestyle interventions, according to research.

Related: How Old Is Your Brain (And How to Make It Younger)

Unfortunately, there are millions of individuals who have cognitive decline and structural changes in the brain that are more dramatic. These people may suffer from either mild cognitive impairment (MCI) or some type of dementia, such as Alzheimer’s disease.

WHAT IS MILD COGNITIVE IMPAIRMENT?

When concerns with memory go beyond what’s considered normal cognitive changes, the symptoms may be due to mild cognitive impairment. Symptoms of MCI include trouble with memory, language, and judgment.

Yet, while the symptoms are more serious than normal cognitive aging, they still don’t impair daily functioning. 

Related: What Is Mild Cognitive Impairment?

It’s estimated that roughly 8 million U.S. adults suffer from MCI—and about 90 percent of them are unaware they have it.

Some of the most common symptoms of mild cognitive impairment may include:

• Forgetting things more frequently
• Missing appointments or social engagements
• Difficulty with language or finding the right word
• Trouble making decisions, finishing tasks or following instructions
• Getting lost in places one knows well
• Poor judgment
• Losing one’s train of thought or failing to follow the plot of a movie or book
• Trouble tracking a conversation
• Family and friends notice these changes

It’s not uncommon for people with MCI to also experience depression, anxiety, short temper/aggression, or a lack of interest in life. More people with MCI than without it will eventually develop dementia.

WHAT IS DEMENTIA AND ALZHEIMER’S DISEASE?

Dementia is an umbrella term for certain neurodegenerative diseases. There are four common types of dementia that damage important brain functions and lead to:

• Cognitive impairment
• Memory loss
• Language difficulties
• Changes in behavior and personality

Dementia significantly interferes with a person’s ability to perform everyday activities like bathing, dressing, cooking, managing finances, driving, and social engagement. As dementia advances, the level of support needed for care and increases as well. 

An estimated 55 million people around the world live with some form dementia. More than 6.5 million U.S. adults currently have Alzheimer’s disease, the most common form of dementia, and that number is expected to double by 2050.

Common signs and symptoms of dementia may include the following:

• Problems with short-term memory
• Difficulty paying bills
• Trouble preparing meals
• Forgetting appointments
• Getting lost in familiar areas
• Difficulty interpreting what is seen
• Struggling with vocabulary, verbal expression, and following conversations
• Impaired judgment
• Loss of restraint/increased impulsivity
• Changes in mood or personality
• Apathy
• Compulsive and repetitive behavior

WHAT CAUSES MCI AND DEMENTIA?

There’s no single cause of MCI and dementia, but rather a host of risk factors that contribute to its development, including:

• Family history of Alzheimer’s disease or other dementia types
• Traumatic brain injury (TBI), including concussions
• Obesity and eating a poor diet
• Diabetes or prediabetes
• Untreated sleep apnea
• Underactive thyroid
• Hypertension or prehypertension
• Lyme disease and other infections that can affect the brain
• Some medications
• Coronary artery disease, including heart problems
• Exposure to toxins
• Alcoholism and substance abuse
• Depression, ADD/ADHD, and posttraumatic stress disorder (PTSD)
• Periodontal (gum) disease
• Chronic inflammation
• Cancer/chemotherapy

WHAT RESEARCH SAYS ABOUT SUPERAGERS

Over two decades ago, researchers at the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University decided to study what is going right in the aging brain as opposed to studying pathology.

They became aware of certain individuals who appeared to defy normal brain aging, more serious memory deficits, and neurodegenerative issues. They sought to study these people in hopes that it might provide information helpful in treating Alzheimer’s disease and other forms of dementia and launched the SuperAging Program in the year 2000.

They coined the term superager and defined it as an individual 80 years or older with a demonstratable memory test score at or above the norm of 50- to 65-year-olds.

During initial recruitment, just 10 percent of the people screened who believed they had outstanding memories were included in the research. Since its inception, the program has studies 290 superagers. A total of 79 of these individuals donated their brains to the program for autopsy research after death.

In an initial study, published 12 years into the program, the researchers noted that superagers exhibit significantly greater cortical thickness and volume than their cognitively normal age-matched peers. In addition, they show no cortical atrophy.

Since this region is associated with attention, and attention supports memory, the finding reveals that keen attention may possibly be what supports the exceptional memory function in superagers.

SUPERAGERS AND SOCIAL CONNECTIONS

In the 2025 study published in Alzheimer’s and Dementia mentioned earlier, the SuperAging Program researchers compiled new and revelatory observations based on over 20 years of data.

Here are some of the characteristic findings about superagers:

• Diverse: The studied superagers were a diverse group of individuals. They did not share a particular healthy diet, exercise regimen, or take a particular medication.
• Extroverted: The superagers were somewhat extroverted and gregarious.
• Place High Value on Connecting Socially: They took time for and valued connecting socially with others.

The importance superagers place on building and maintaining social connections was one of the most significant commonalities noted about them.

Their high sociability makes sense and even aligns with previous studies on aging populations. Indeed, social connections and aging well are closely linked.

Highly social people are more resistant to cognitive decline as they grow older, research shows. Studies also suggest a link between larger brain size and greater social connectedness.

On the other hand, loneliness, defined as having a lack of meaningful social connections, appears to have a detrimental impact on aging brains as it is associated with cognitive decline, memory loss, and increased dementia risk.

A 2024 review study on loneliness and aging analyzed data from more than 600,000 participants. It found that feeling lonely increases the risk for dementia by 31 percent.

Related: 7 Ways to Be Less Lonely

While other factors are at play in superagers, this finding alone speaks volumes in terms of the potential protections an aging brain may enjoy from an individual developing strong social connections.

SUPERAGERS AND THE BRAIN

Scientists have discovered that superagers’ brains have special features that help explain why they stay sharp and socially connected well into later life.

Here’s what makes their brains different:

• Resist Alzheimer’s Changes: Superagers show fewer buildups of amyloid and tau proteins (the changes often seen in Alzheimer’s disease). And even when small amounts are present, they don’t seem to harm memory.
• More Memory Cells: They have higher numbers of neurons in the entorhinal cortex—a brain area that plays a big role in making memories, processing what you see and hear, and helping you navigate spaces.
• Special Social Neurons: Their brains contain more von Economo neurons—rare brain cells also found in highly social animals like dolphins, whales, and great apes. These cells are linked to empathy, self-awareness, and managing emotions. Having more of them may explain superagers’ strong social connections.
• Stronger Attention and Learning System: Superagers’ cholinergic system—which supports focus, learning, memory, and even blood flow—stays healthier compared to others their age.
• Lower Brain Inflammation: They have fewer overactive immune cells (called microglia) in their brain’s white matter. Too many of these cells are linked to Alzheimer’s and other memory problems.

HOW TO BECOME A SUPERAGER

Being more social may be one of the keys to achieving superager status. However, researchers believe what it’s probably a combination of behavior, as well as genetics and biology that makes superagers.

That said, building and maintaining meaningful social connections may help to protect your memory and brain function. Enjoying quality social connections, of course, will also add to your overall well-being.