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Perinatal Depression: What It Is and How to Cope

Perinatal Depression: What It Is and How to Cope

Britney Spears announced she's expecting a baby on Instagram this week and also revealed that she had perinatal depression when she was pregnant previously.

"I have to say it is absolutely horrible," Spears wrote. "Women didn't talk about it back then." 

Perinatal depression is a mood disorder that can start during pregnancy or after childbirth, while postpartum depression specifically describes depression someone develops after giving birth. While the direct causes of the disorders vary, the anxiety, sadness, apathy and other emotions many new or soon-to-be parents feel can be difficult to describe to loved ones or bring up at a doctor's appointment. 

Despite this, it's a common medical experience during pregnancy or the postpartum period. According to the American College of Obstetricians and Gynecologists, one in seven women will experience perinatal depression. 

Julianne Zweifel is a clinical psychologist and adjunct professor at UW Health in Madison, Wisconsin who works with people who have postpartum mood dysregulation, which can vary from postpartum "baby blues" to postpartum depression. In a September interview with CNET, she said the pressure to feel a certain way can lead new parents to feel inadequate when they don't feel what they perceive to be the "right" feelings.

"I like to describe it as [being] analogous to having only seen black-and-white photos all your life, and suddenly [you] see color photos," Zweifel said about new parents' expectations. "Like, 'wow, I didn't even recognize this dimension existed.'" 

The hormonal surges and lifestyle changes pregnancy and new parenthood bring can have dramatic effects on someone's mental health. If you're feeling society's expectation of how pregnant people and new parents should feel doesn't reflect your experience, here's what to know about perinatal and postpartum depression.

Depression during pregnancy 

During pregnancy, your body goes through huge changes as it accommodates a new body and prepares for the marathon of childbirth (and parenthood). On top of the physical and hormonal changes, pregnancy can put strain on relationships and cause financial stress. But like depression in people who aren't pregnant, it may also have genetic causes. 

According to the Cleveland Clinic, you're more at risk of experiencing depression during your pregnancy if: 

• You have a history of depression or premenstrual dysphoric disorder (PMDD, or severe PMS that disrupts daily life).
• You became pregnant at a younger age (risk decreases as age increases). 
• You live alone or have limited social support.
• You're experiencing marital problems.
• You have mixed feelings about your pregnancy.

The pandemic may also have increased the rate of anxiety or depression during pregnancy.

While depression can strike at any time in life, many people experience anxiety or depression for the first time while they're pregnant. Because depression can affect the health of the pregnant person and growing fetus, it's important to see your doctor or a mental health professional if you're experiencing symptoms of depression for at least two weeks, the ACOG says. Symptoms include, but aren't limited to: 

• Depressed mood most of the day, for most days. 
• Feeling guilty, hopeless or worthless. 
• Loss of interest in work or activities. 
• Sleep problems (sleeping too much or having problems going to sleep).
• Big changes in appetite (losing appetite, or eating much more than normal).
• Having trouble concentrating or making decisions. 
• Thinking about death or suicide.

Treatment for depression during pregnancy may be similar to treatment for people who aren't pregnant, including talk therapy or medication, according to the ACOG. 

Resources and an expert hotline to call for people experiencing depression during pregnancy and the postpartum period can be found at Postpartum Support International. An analysis of anxiety and depression in pregnant people during the pandemic found that increased social support and physical activity reduced the likelihood of developing either disorder during pregnancy.

Postpartum blues vs. postpartum depression

Zweifel said as many as 65% to 70% of people will experience postpartum "baby blues," or mood swings that begin roughly within a week of delivery. "Once you start using numbers like that, that means that's the normal response," she said. But baby blues will resolve on its own, usually getting better in about seven to 10 days. If feelings of classic depression persist without showing signs of getting better after about two weeks, Zweifel said, it's likely postpartum depression.

Symptoms of postpartum depression can be more intense and last longer than baby blues, and can potentially interfere with your ability to care for your baby or handle daily tasks, according to the Mayo Clinic. PPD can manifest differently and may include typical symptoms of depression, such as severe mood swings, feelings of worthlessness and a withdrawal from family and friends, but may also include feelings specific to your role as a parent, including feelings that you're not a good parent or thoughts and fears that you'll harm your child, per the Clinic. 

Zweifel wants to clear up the misconceptions about PPD and the idea that it makes people harm their child. 

"Somehow, our society has assumed that's a part of the scenario, and I feel like that's part of the problem," she said. There is a big difference, she said, between fearing that you'll "lose control" and hurt your child, or having intrusive thoughts of you dropping them, than of actually harming your child. "The intent is different there," Zweifel said. 

Postpartum psychosis is a very rare condition which can result in the afflicted person attempting to harm themselves or their baby. According to the Mayo Clinic, some of the signs of postpartum psychosis include confusion, paranoia, excessive energy and agitation, hallucinations and delusions. 

Read more: 13 Suicide and Crisis Intervention Hotlines to Call or Text When You Need Help

Having a baby with colic, frequent and intense crying in a healthy infant, can increase the risk of postpartum depression in new parents, per the Mayo Clinic. 

damircudic/Getty

Postpartum depression causes

Many factors can contribute to depression after childbirth, including social factors like not having a support system, societal pressure to feel a certain way and the way a person's body reacts to hormonal changes.

Hormones

Estrogen and progesterone levels skyrocket during pregnancy and then very quickly after birth, they start to drop. This huge dip in hormones is what causes many people to experience strong emotions following birth. 

Research suggests that there's not different hormone levels or amounts in people who experience PPD compared to people who don't, Zweifel said. But there might be a difference in how their brain responds to changes in estrogen. Zweifel called the varying chemical effect of estrogen as a "prominent working theory," but it helps explain why oftentimes the people who experience severe mood changes in connection with their menstrual cycle may also be more likely to experience PPD or have more mood-related symptoms during menopause. 

"That subset is experiencing the same changes and same patterns," Zweifel said. "But the receptor sites in their brain, essentially, sort of respond differently. They're extra sensitive."

Outside factors

Zweifel said a lot of people experiencing symptoms of depression who come into her office feel better almost immediately after she dispels myths about what makes someone an inferior parent -- missing the "golden hour" of contact with a newborn for medical reasons, for example, or choosing to formula feed instead of breastfeed. Another record she has to set straight is the idea that all parents have an immediate bond with their infant, and if they don't, it means there's something wrong with them. 

"Bonding with an infant takes time, and our society does a terrible job of being honest with women about this," Zweifel said. She likes to instill the idea of a "fourth trimester," because there's still so much developing happening on the baby's end in the first few weeks of life that makes the parent-child relationship very straining on the parent, often leaving them "starved for validation" because the baby isn't able to acknowledge the parent, or even able to focus their eyes yet. 

In addition to unrealistic expectations of what it means to be a parent, Zweifel said other factors like being the only parent who gets up when the baby cries can exacerbate PPD, or having a child with acid reflux or other medical conditions that require extra care. 

Other risk factors, per the CDC, include being a parent to multiples (twins, triplets or more), being a teen parent, having a family or personal history of depression, having a preterm or complicated birth, experiencing difficulty getting pregnant and other stressful events surrounding pregnancy. 

Noncarrying parents can also develop postpartum depression.

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PPD is also not a limited experience to the person giving birth. Although the other parent won't be experiencing the hormonal changes that can cause symptoms of depression, similar lifestyle changes, added stress, lack of sleep and societal pressure remain. A 2014 study published in the journal Pediatrics found that depression among new dads increased an average of 68% the first year of their child's life.

If your mental health is a concern to you, reach out for help. If you're interested in seeking treatment with medicine, Zweifel recommends finding a psychiatrist or another professional who works specifically with people on postpartum mood dysregulation.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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Trouble Sleeping? Your Diet Could Be Preventing Quality Rest

Trouble Sleeping? Your Diet Could Be Preventing Quality Rest

The food you eat impacts almost everything you do, which is one reason why it's so important to be conscious of what you put in your body. Good nutrition has tons of perks: It reduces the risk of diseases such as stroke, Type 2 diabetes and heart disease, boosts your mood and makes you feel more energized. It can even improve how you sleep at night, another major aspect to having a healthy body and mind. A full night's sleep offers a lot of the same benefits as conscious eating. In fact, they go hand in hand.

Eating the wrong foods at the wrong time can be harmful to your sleep quality, which plays an important role in maintaining your physical and mental health. On the flip side of the same token, you have a higher chance of making poor food choices after a night of bad sleep. Below, learn how you can improve your food choices to get higher-quality rest, including the best foods for better sleep and what you need to avoid. 

Read also: How to Stay Cool at Night Even When It's Hot Outside

How poor sleep affects your health

The recommended amount of sleep for adults is seven to nine hours each night. During that time, your brain cycles through the four stages of sleep: three stages of NREM (non-rapid eye movement) and one stage of REM (rapid eye movement). 

• NREM sleep: The quiet sleep stages where your brain is working to retain memories and knowledge, in addition to repair, refresh, and restore your body. 
• REM sleep: The active sleep stage where your body is working to repair cells and muscle tissue, promote bone and muscle growth and helps strengthen the immune system. 

If you're waking up often in the middle of the night or have trouble getting a full night's sleep, you prevent your body from running through its necessary processes that keep you healthy and productive. Continuous poor sleep puts you at risk for:

• Heart disease
• Stroke
• Weight gain
• High blood pressure
• Bad memory
• Weakened immune system

Unbalanced nutrition tends to be a common culprit for poor sleep, especially if you're eating certain foods too close to bedtime. 

There's several foods you shouldn't eat too close to bedtime. 

Natalia Lavrenkova/EyeEm/Getty Images

Nutrition for quality sleep

There seems to be a clear link between nutrition and your quality of sleep. To find out more, I spoke to Stephanie Nelson, a registered dietitian who works as a nutrition expert at the tracking app MyFitnessPal. Nelson explained, "The relationship between sleep and nutrition is very complex and we don't know everything about all the associations between sleep and food. However, a good general summary is that any biological process, including sleep, is influenced by getting the right amount of nutrients. "

"For example, having high blood sugar impacts your energy in the moment, which can prevent you from sleep," Nelson continued. "Other nutrients impact neurotransmitters that make it easier to relax and turn your brain off for sleep." 

While food affects sleep, the amount of quality sleep you get can also impact your eating habits. Nelson said, "Interestingly, the relationship goes both ways. There's research showing that poor sleep can negatively impact hormone balances that affect your hunger, and people who sleep less tend to eat more overall."

Making more conscious choices about food and when you're eating it can make a big difference in your sleep quality.

The do's and don'ts on eating for better sleep

Here are Nelson's tips on how to eat for better sleep. 

Do's

1. Eat a balanced dinner 

"The building blocks of a balanced dinner are a protein source, high-fiber carbohydrate source, and a vegetable. This might look like a grilled marinated chicken breast, some quinoa, and roasted veggies," said Nelson. "You could also get more creative with it, like a coconut curry made with tofu and sauteed veggies, served over brown rice, or tacos made with the protein of your choice, some beans, and cabbage and onions (and all your other favorite toppings)." 

A balanced diet is critical to good sleep. 

Getty Images/Burcu Atalay Tankut

2. Eat foods that promote serotonin production

Serotonin is required for your body to make melatonin, the hormone responsible for regulating sleep. But Nelson also warns that toomuch serotonin is associated with poor sleep. 

"In order for your body to produce the right amount of serotonin, you need to consume tryptophan, an amino acid you can find in most animal-based foods, oats, nuts, and seeds," Nelson explained. "You also need to have a carbohydrate source, which allows for tryptophan to be used for serotonin rather than other processes. Other nutrients like vitamin B6, present in sweet potatoes among other foods, are also needed for the right amount of serotonin production."

3. Eat around three hours before bedtime

You might have heard that you shouldn't eat right before bedtime if you want a good night's rest. But how soon, exactly, should you stop eating? "It's different for everyone," said Nelson. "Most experts recommend to eat three hours before bedtime for best sleep results, so start there, but definitely play with it. Some people can eat closer to bedtime and still have a good night's sleep," she said.

Don'ts

1. Avoid caffeine, sugary drinks and alcohol before bed

You probably know that caffeine isn't the best nighttime beverage, but what about alcohol or juices? Nelson says you should try to avoid those in the hours right before bed too.

"Being hydrated is key to a good night's sleep," she said. "Alcohol dehydrates you, so for the first step, reduce alcohol consumption near bedtime. High sugar drinks also can interfere with sleep, and anything with caffeine." 

"If you're having trouble sleeping, definitely check when your most recent caffeinated beverages are consumed before bed," she noted.

2. Don't eat dessert close to bedtime

For individuals with a sweet tooth, don't eat foods like ice cream, cookies or chocolate before bedtime. Nelson explains that "low-fiber, high-sugar snacks before bed can cause a spike and then a drop in blood sugar." These irregular blood sugar levels can disrupt your sleep in multiple ways, making it hard for you get deep rest.

Try not to eat high-sugar snacks before bed.

LordHenriVoton/Getty Images

3. Don't overdo late-night indulgences

"Eating large amounts of any type of food too close to bedtime will probably affect your sleep, especially if it's high in sugar or fat. On the flip side, if you go to bed hungry that might also negatively impact your sleep," Nelson said 

Life happens, and sometimes you need a midnight snack to avoid falling asleep with your stomach growling. Nelson advises eating something that's small, high in fiber and pairing it with protein "to keep your blood sugar from spiking and to keep you full until morning." She adds, "Try a banana with peanut butter or a handful of berries with yogurt." 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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These 5 Tips Make Sleeping With a CPAP Machine Easy

These 5 Tips Make Sleeping With a CPAP Machine Easy

Sleeping with a CPAP machine can be annoying -- the mask covering your face, the hose tethering you to a machine that grumbles beside your bed. We get it. Undeniably, they can be a hassle, and that's a big reason why people opt to sleep without them. Up to 35% of people don't use their prescribed CPAP machine as intended. Some people only use it for a few hours each night, while others disregard it entirely. 

We don't recommend doing that. Ignoring sleep apnea is serious as heart disease and high blood pressure. Instead of compromising your sleep quality and health, use these quick tips to make sleeping with a CPAP mask part of your routine. 

1. Pick the right mask style

The good news is that CPAP machines have come a long way from the clunky old noise machine with a huge face mask. Newer models are very quiet, and there are various mask styles you can choose from. Modern CPAP machines offer mask variations that allow you to choose what works best for you.

Common CPAP mask styles: 

• Full-face masks: This coverage option is what people expect from CPAP machines. It covers both your mouth and nose. It's a good option for people with nasal congestion or those who breathe through their mouths at night. 
• Nasal mask: This mask only covers your nose. It's well suited for people who move around in their sleep. 
• Nasal pillow mask: This mask has the smallest face covering -- it sits across your upper lip and nostrils. This option is great for people who feel claustrophobic in full coverage options or wear glasses. 
• Oral mask: This mask covers only your mouth and is best suited for people who breathe out of their mouth at night.

Keep in mind what position you sleep in when choosing the style of mask. If you sleep on your stomach or side, the larger masks with various straps may push against your pillow.

2. Make sure your mask fits properly

Once you know which mask style best fits your needs, you must ensure it fits. An ill-fitting mask is uncomfortable and can leave you with a dry, stuffy nose. If you notice red marks on your face, it's too tight. On the other hand, you won't get the benefits CPAP machines offer if the mask is too loose. 

Make adjustments each night until you find the perfect fit. When you adjust your mask, you should do so while lying down with the mask on your face. If you are having trouble getting your mask to fit properly, your doctor will be able to help you adjust the mask accordingly. 

Getty Images/cherrybeans

3. Practice wearing it during the day

When you first put on a CPAP mask, it can feel a bit like having a facehugger from Alien clamped to your face. It takes time to get used to. The last thing you want to do is save the adjustment period for when you are trying to fall asleep. Instead, start wearing it during the day so you get used to the sensation of being on your face. Wear it while you're watching TV or reading a book. Soon enough, you won't notice it at all. 

If you find that you can't tolerate wearing it during the day, try breaking it down into steps. Start with just the mask -- no hose or straps. Then slowly attach the hose and straps to the process.

4. Use the 'ramp' feature

CPAP machines are designed to push air into your airways to keep them from collapsing from sleep apnea. For some people, the feeling of forced air is hard to tolerate, especially in the beginning. Many CPAP machines have a "ramp" feature that starts with lower air pressure as you fall asleep and increases through the night. Work with your doctor to find your prescribed optimal pressure for your sleep apnea.

5. Be patient

Getting used to sleeping with a CPAP machine is an ongoing process that you should measure in terms of small steps. No one brings home their brand-new CPAP machine and immediately sleeps eight uninterrupted hours with it on. CPAP machines can help you sleep better and ultimately improve your health in the long run. Despite the sometimes annoying CPAP struggles, you'll feel more rested if you sleep with it.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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9 Tips to Help You Sleep Better While You're on the Road

9 Tips to Help You Sleep Better While You're on the Road

Whether you're going on vacation, a work trip or visiting family for the holidays, all that traveling can take a toll on your sleep... especially if you're crossing time zones. From bumpy plane rides to long car trips and the jet lag that comes with time changes, getting proper sleep while traveling isn't always easy. This is especially true if traveling itself makes you anxious. All of these disruptions can add up to travel fatigue, which can lead you to feel groggy, cranky and exhausted. 

A full night's sleep is a crucial part of maintaining your physical and mental health. It promotes brain functions, repairs muscle tissue and boosts your mood so you can be your best self while you're away. Consider the tips below to help cure poor-sleep woes for your next trip and get better sleep while traveling.

What is travel fatigue?

Travel fatigue is the physical manifestation of travel's grievances. It can happen for instances such as: having anxiety about flying on a plane, stress from planning, long layovers, delayed flights or lack of sleep during travel. And although you're mentally drained, travel fatigue can make it more difficult to get restful sleep. 

Jet lag

Aside from travel fatigue, jet lag during travel can also make it a struggle to achieve quality sleep. Jet lag is a temporary sleeping disorder that develops when you cross time zones, and your body is thrown out of whack from its regular sleep-wake cycle. 

Our body heavily depends on outside factors like sundown, sunrise and eating times to regulate the release of melatonin. As a result, your body has a difficult time readjusting during travel, leaving you feeling tired and having difficulty concentrating. 

How to sleep better during travel 

Combat travel fatigue, jet lag and uncomfortable sleeping circumstances by following these tips. 

Prepare your body for the new schedule

Starting three days before you go, set your bedtime an hour later (depending on the time zone of where you're traveling) each day. This will help your body become accustomed to the new time change that you'll be experiencing in a few days, and allow you to fall asleep at a reasonable time when you're away. 

An exception to this rule: If you expect to be gone across time zones for only two days, stick to your regular sleeping schedule. By the time you adjust to the new time, you'll be getting ready to head back home.  

Do as the locals do

Once you arrive at your destination, try to sync up to their schedule. When people are awake in the morning and out-and-about, you should be, too. When the people around you are gearing up for bed, you should be about ready to hit-the-hay, as well. Unless your stay is two days long, this will help your body readjust even if it means you'll be half-asleep at dinner. 

Pack comfy 

Pack your comfiest clothes for travel and a pillow to sleep with if you can fit it inside your suitcase. Loose-fitting fabrics can help you feel comfortable while you travel long distances, which is key if you're hoping to get some sleep while on the road. 

A pillow can also make it easier to fall asleep. Bring a standard pillow for the back seat of a car or a C-shaped pillow to wrap around your neck while on a plane or train. 

Eat nutritiously and drink water

Staying hydrated and eating well while traveling not only will help you remain fueled up for different stages of travel, but it will also keep you from feeling hungry or thirsty if you want to doze off on the plane or in the car. 

Use light to your advantage

The sun is a signal to our circadian rhythm that it's time to be awake, and the night tells us it's time for sleep. 

If you travel from west to east, the best times of day to get light exposure are the late morning and late afternoon. That way, you stay awake and vigilant during the day, but you give your body the chance to wind down into the nighttime. If you travel from west to east, remain in the sun into the evening to help adjust to the new time.

Avoid alcohol on your first day

Hear me out. As fun as it is to get a drink on the airplane on the way to your destination or at dinner when you arrive, alcohol messes with your sleep-wake cycle. This is something you want to avoid during your first day of getting acclimated to the new time. 

Avoid caffeine and nicotine 

Caffeine and nicotine are stimulants that will make your body feel like it wants to be awake. Caffeine can stay in your system for up to five to six hours, making you feel wired when you should be winding down for bed. Nicotine, on the other hand, causes cravings and has no time limit. That means you can be laying awake in bed feeling tired, but your body stays awake wanting more nicotine.  

If you have to stay awake, keep moving

Like light, body temperature also plays an important role in regulating our sleep-wake cycles. If your body is higher in temperature, it's a signal that it's time to be awake. It's a reason why hot sleepers can have trouble getting quality sleep if they're too warm. By keeping your body in motion and your heart rate up, you can help fight grogginess and fatigue that come with travel. 

Use natural sleep aids 

Melatonin is always an option, but I'm always wary of recommending it, because it can mess with your body's natural production of melatonin. As an alternative, consider using natural sleep aids to help you fall asleep at night like herbal tea or CBD oil.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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6 Weight Loss Mistakes That Are Holding You Back

6 Weight Loss Mistakes That Are Holding You Back

Unlike what social media influencers would have you believe, the vast majority of people who lose weight don't maintain it for longer than a year. For most people, the weight eventually comes back in a phenomenon known as "weight cycling." And no, it has nothing to do with "falling off the wagon."

Your weight doesn't determine your health, so if you're finding weight loss to be a frustrating and fruitless feat, you have our permission to give it up and focus on other aspects of your wellness instead. But if you're committed to weight loss as a goal, there are some pitfalls that you can avoid to help improve your chances of success. Here's what not to do.

A short-term attitude

Everything on this list is somewhat of a hard truth, but this is often the hardest to accept (and change). If you approach weight loss with a short-term attitude, you may not make it anywhere except on the yo-yo diet train. 

Without a long-term approach to weight loss, you may lose 10 or more pounds in two weeks and then suffer a rebound when you discover that regimen wasn't working for you. This is all too common when people embark on strict diets such as keto or paleo, or fad diets that promise rapid weight loss. In reality, for most people, a well-balanced diet that includes all food groups and even some treats works best in the long run. 

Part of successful, sustainable weight loss -- i.e. losing the weight and keeping it off for good -- is understanding that fad diets, excessive exercise and "detoxes" don't usually work. They only last as long as your willpower lasts, and I'm willing to bet that's not more than two weeks to a couple of months. 

There are no quick fixes, miracle cures or magic pills when it comes to weight loss, despite what the wellness industry might have you believe: Losing weight requires dedication to a plan that supports long-term healthy habits. 

The general recommendation for weight loss is a rate of one to two pounds per week, although initial weight loss might surpass that for people who are very overweight, and then slow down to the suggested one to two pounds per week. Studies have shown this to be an effective way to lose weight without losing too much water or lean tissue -- and to avoid a rebound. 

Overcoming an all-or-nothing mindset promotes long-term weight loss.

Malte Mueller/Getty Images

An all-or-nothing mindset

Many people who struggle with a short-term attitude also struggle with an all-or-nothing mindset. I myself began my health and fitness journey with this mindset. I cut out all (literally all!) processed foods: no bread, no pasta, no milk, no cheese, definitely no individually wrapped snacks. I basically existed on chicken, vegetables and berries. 

This was great until it wasn't, and I ended up on a CVS run for all the chocolate and Goldfish I could hold in two hands. Then, because I'd "ruined" my diet, I would eat as much as I could physically handle, because, "Why not? I already ruined it." 

Then, of course, I'd feel bad about the snacks I ate and return to my overly restrictive regimen the next day. This is a destructive cycle to be in, but it's something I see all the time with personal training clients. An all-or-nothing mindset can keep you in a perpetual cycle of lose-gain-lose, not to mention shame and guilt around food. 

This all-or-nothing concept applies to fitness, too: If you've been The most effective workouts to get in shape in the least amount of time left and right but don't feel fitter or stronger, you might be doing too much. Toning it down could -- counterintuitively -- be the answer to improving your fitness (and playing the long game). 

A supportive community, IRL or online, can keep you motivated to lose weight and stay fit.

Thomas Barwick/Getty Images

A poor support system

Supportive friends, family members and significant others are critical to successful weight loss. If I was asked to cite the most common reason for not sticking to a healthy diet from my past personal training clients, I would say stigma. 

That's right. As silly as it sounds, people really do get made fun of for eating healthy, especially in regions where food is an integral part of the culture. Growing up in southern Louisiana near New Orleans, I experienced this very often when I decided I was making changes to my diet.

At family gatherings and social outings, I'd get comments like, "That's all you're eating?" or, "You're really not going to eat any dessert?" or, laden with sarcasm, "Next time we'll have a salad potluck."

It's not fun to be ridiculed or scoffed at, especially for things you care about (like your health!), so it can be very easy to fall into a trap of eating -- and drinking -- for the sake of your social life. This is why a solid support system is key to long-term weight loss. Without it, the journey can feel lonely and intimidating. 

If you currently feel you lack a support system, try having open conversations with your friends, family and partner about it. You can make it clear that they don't have to change their eating habits if they don't want to, but that your health means a lot to you and you'd appreciate it if they didn't mock or downplay your hard work. 

If an IRL support system isn't working out, turn to online communities that promote both health and body positivity. I really love Flex and Flow on Instagram, Health At Every Size and the Intuitive Eating Community. These communities emphasize health without emphasizing weight, which is helpful because when you focus on the health outcomes, you'll reach your happy weight with ease. Reddit also has a great forum (/r/loseit) where you'll find lots of real-life stories about weight loss. 

Exercise is important for an overall healthy lifestyle, but it's hard to lose weight from exercise alone.

Tetra Images/Getty Images

Thinking exercise conquers all

If you're at all attuned to the wellness industry, you'll know this saying: "Abs are made in the kitchen, not the gym." Even if your goals don't include a shredded stomach, the adage is still relevant. You just can't out-exercise a poor diet. 

Exercise should definitely be part of your overall approach to weight loss because it's proven to aid weight loss (not to mention its long list of other health benefits), but it's difficult to lose weight from exercise alone. Many people overestimate the number of calories they can burn from their workouts -- it's probably a lot less than you think. 

For example, a 154-pound man will burn fewer than 450 calories during an intense, hour-long weight lifting workout. You can easily cancel that effort out if you don't pay any attention to your diet. The exact number of calories you burn during exercise depends on many factors, including your current weight, the intensity of the activity, the length of the workout, your age and your body composition.

Plus, focusing on only exercise can lead to a destructive cycle of exercising extra to burn off calories you feel you shouldn't have eaten. Or you may end up feeling like you need to "earn" your calories through exercise. Either way, taking this approach can lead to a strained relationship with food and exercise, as well as stalled weight loss. 

There are exceptions to all rules. Some people, such as those who have spent years putting on muscle mass, can eat lots of calorie-dense food and not gain weight -- but even if you can eat whatever you want and lose or maintain your weight, that doesn't mean it's healthy for you. 

A diet rich in fruit, vegetables, healthy fats, lean proteins and some whole grains will serve you best in terms of sustainable weight loss and health. Combined with a consistent exercise routine, you'll experience sustained weight loss and weight maintenance once you reach your goal weight.

Chronic stress and sleep deprivation can hinder weight loss progress.

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Sleep, stress and work

Losing weight will be a helluva lot harder if you're chronically stressed, sleep-deprived or overworked. This scenario may sound familiar to you: 

• You wake up motivated and ready to seize the day. You have plans for a post-work interval run and your healthy, prepped dinner is waiting in the fridge for you.
• A few hours into the day, your lack of sleep catches up with you. You reach for the afternoon coffee. 
• By the time work is over, you're way too drained to go for that run. You decide to skip it. 
• You're tired and maybe a little stressed or moody, so you nix the healthy dinner and hit a drive-through instead -- because comfort food.

This is OK if it happens occasionally (everyone deserves a lazy evening every once in a while), but weight loss will seem impossible if this happens all the time.

The truth is, nutrition and exercise are only two components of a healthy life that can lead to weight loss. While important, too strong of a focus on nutrition and exercise can cause you to overlook other factors that are just as important: sleep and stress management. 

Supplements don't work unless you do.

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Depending on supplements

I hate to be the bearer of bad news, but that fat burner supplement in your medicine cabinet isn't going to do the work for you. While certain supplements may help you reach your weight loss goals, you have to work to make your supplements work. 

For example, incorporating a daily protein shake in the mornings can help you feel fuller throughout the day, which may help keep cravings at bay. Increased protein intake can also help you build muscle, which aids in body recomposition. 

Certain weight-loss supplements do have some evidence backing them, but no supplements are proven like the method that no one wants to take: eat fewer calories than you burn. 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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