How White Is Your Tongue?

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It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small

❝So its normal to develop a white sort of coating on the tongue, right? It develops when I eat, and is able to (somewhat) easily be brushed off❞

If (and only if) there is no soreness and the coverage of the whiteness is not extreme, then, yes, that is normal and fine.

Your mouth has a microbiome, and it’s supposed to have one (helps keep the conditions in your mouth correct, so that food is broken down and/but your gums and teeth aren’t).

Read more: The oral microbiome: Role of key organisms and complex networks in oral health and disease

The whiteness you often see on a healthy tongue is, for the most part, bacteria and dead cells—harmless.

Cleaning the whiteness off with your brush is fine. You can also scrape off with floss is similar if you prefer. Or a tongue-scraper! Those can be especially good for people for whom brushing the tongue is an unpleasant sensation. Or you can just leave it, if it doesn’t bother you.

By the way, that microbiome is a reason it can be good to go easy on the mouthwash. Moderate use of mouthwash is usually fine, but you don’t want to wipe out your microbiome then have it taken over by unpleasantries that the mouthwash didn’t kill (unpleasantries like C. albicans).

There are other mouthwash-related considerations too:

Toothpastes and mouthwashes: which kinds help, and which kinds harm?

If you start to get soreness, that probably means the papillae (little villi-like things) are inflamed. If there is soreness, and/or the whiteness is extreme, then it could be a fungal infection (usually C. albicans, also called Thrush), in which case, antifungal medications will be needed, which you can probably get over the counter from your pharmacist.

Do not try to self-treat with antibiotics.

Antibiotics will make a fungal infection worse (indeed, antibiotic usage is often the reason for getting fungal growth in the first place) by wiping out the bacteria that normally keep it in check.

Other risk factors include a sugary diet, smoking, and medications that have “dry mouth” as a side effect.

Read more: Can oral thrush be prevented?

If you have any symptoms more exciting than the above, then definitely see a doctor.

Take care!

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  • Infections, Heart Failure, & More

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Some health news to round off the week:

    The Infection That Leads To Heart Failure

    It’s long been held that, for example, flossing reduces heart disease risk, with the hypothesis being that if plaque bacteria enter the blood stream, well, that’s an even worse place for plaque bacteria to be. Now, with much more data, attention has turned to

    1. actual infections, and
    2. actual heart failure

    Way to up the ante! And, it holds true regardless of what kind of infection. So, you might think that a UTI, for example, is surely “downstream” and should not affect the heart, but it does. Because of this, researchers currently believe that it is not the infection itself, so much as the body’s inflammation response to infection, that leads to the heart failure. Which is reasonable, because, for example, atherosclerosis is made mostly not of cholesterol itself, but rather mostly of dead immune cells that got stuck in the cholesterol.

    Moreover, it’s not so much about the acute inflammatory response (which is almost always a good thing, circumstantially), but rather that after cases where an infection managed to take hold, the immune system can then often stay on high alert for many years alter. Long COVID is an obvious recent example of this, but it’s hardly a new phenomenon; see for example post-polio syndrome, and consider how many more such post-infection maladies are likely to exist that never got a name because they flew under the radar or got diagnosed as fibromyalgia or something (fibromyalgia is a common diagnosis doctors give when they acknowledge something’s wrong, and it causes pain and exhaustion, but they don’t know what, and it appears to be stable—so while it can be helpful to put a name to the collection of symptoms, it’s a non-diagnosis diagnosis on the doctors’ part. It’s saying “I diagnose you with hurty tiredness”).

    The take-away from all this? Avoid infections, for your heart’s sake, and if you do get an infection, take it seriously even if it’s minor. The safe amount of infection is “no infection”.

    Read in full: Study uncovers new link between infections and heart failure

    Related: What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring

    Cold Water Immersion: Hot Or Not?

    The evidence is clear for some benefits; for others, not so much:

    • It’s great (if you’re already in fair health, and definitely not if you have a heart condition) to improve circulation and stress response
    • There may be some benefits to immune function, but however reasonable the hypothesis, actual evidence is thin on the ground
    • The oft-hyped mood benefits are a) marginal b) short-lived, with benefits fading after 3 months of regular cold baths/showers/etc

    Read in full: The big chill: Is cold-water immersion good for our health?

    Related: Ice Baths: To Dip Or Not To Dip?

    The Unspoken Trials Of Going To The Gym (While Being A Woman)

    Public health decision-makers often think that getting people to go to the gym more is a matter of public information, or perhaps branding. Some who have their thinking heads on might even realize that there may be economic factors for many. But for women, there’s an additional factor—or rather, an additionally prominent factor. The study we’ll link started with this observation (please read it in the voice of your favorite nature documentary narrator):

    ❝Despite an increase in gym memberships, women are less active than men and little is known about the barriers women face when navigating gym spaces.❞

    What then, of these shy, elusive creatures that make up a mere 51% of the world’s population?

    A medium-sized (n=279) study of women, of whom 84% being current gym-goers, reported often feeling “judged for their appearance or performance, as well as having to fight for space in the gym and to be taken seriously, while navigating harassment and unsolicited comments from men”

    Even gym attire becomes an issue:

    ❝Aligning with previous literature, women often chose attire based on comfort and functionality. However, their choices were also influenced by comparisons with others or fear of judgement for wearing non-branded attire or looking too put together. Many women also chose gym attire to hide perceived problem areas or avoid appearance concerns, including visible sweat stains.❞

    …which main seem silly; you’re at the gym, of course you’re going to sweat, but if you’re the only one with visible sweat stains, then there can be social consequences (bad ones).

    Similarly, there’s a “damned if you do; damned if you don’t” when it comes to working out while fat—on the one hand, society conflates fatness with laziness; on the other, it can be extra intimidating to be the only fat person in a gym full of people who look like they’re going to audition for a superhero movie.

    ❝In the gym, just like in other areas of life, women often feel stuck between being seen as ‘too much’ and ‘not enough’, dealing with judgement about how they look, how they perform, and even how much space they take up. Even though the pressure to be super thin is decreasing, the growing focus on being muscular and athletic is creating new challenges. It is pushing unrealistic standards that can negatively affect women’s body image and overall well-being.❞

    Writer’s note: I live a few minutes walk from my nearest gym, and I work out at home instead. This way, if I want to do yoga in my pajamas, I can. If I want to use my treadmill naked and watch my T+A bounce in the mirror, I can. If I want to lift weights in the dress I happened to be wearing, I can. Alas that I can’t swim at home!

    Read in full: Women face multiple barriers while exercising in gyms

    Related: Body Image Dissatisfaction/Appreciation Across The Ages

    Take care!

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  • Inheritance – by Dr. Sharon Moalem

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    We know genes make a big difference to a lot about us, but how much? And, the genes we have, we’re stuck with, right?

    Dr. Sharon Moalem shines a bright light into some of the often-shadowier nooks and crannies of our genetics, covering such topics as:

    • How much can (and can’t) be predicted from our parents’ genes—even when it comes to genetic traits that both parents have, and Gregor Mendel himself would (incorrectly) think obvious
    • How even something so seemingly simple and clear as genetic sex, very definitely isn’t
    • How traumatic life events can cause epigenetic changes that will scar us for generations to come
    • How we can use our genetic information to look after our health much better
    • How our life choices can work with, or overcome, the hand we got dealt in terms of genes

    The style of the book is conversational, down to how there’s a lot of “I” and “you” in here, and the casual style belies the heavy, sharp, up-to-date science contained within.

    Bottom line: if you’d like insight into the weird and wonderful nuances of genetics as found in this real, messy, perfectly chaotic world, this book is an excellent choice.

    Click here to check out Inheritance, and learn more about yours!

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  • 4 Critical Things Female Runners Should Know

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When it comes to keeping up performance in the face of menopause, Shona Hendricks has advice:

    Don’t let menopause run you down

    1. Prioritize recovery! Overtraining without adequate recovery just leads to decreased performance in the long term, and remember, you may not recover as quickly as you used to. If you’re still achey from your previous run, give it another day, or at least make it a lighter run.
    2. Slow down in easy and long runs! This isn’t “taking the easy way out”; it will improve your overall performance, reducing muscle damage, allowing for quicker recovery and ultimately better fitness gains.
    3. Focus on nutrition! And that means carbs too. A lot of people fighting menopausal weight gain reduce their intake of food, but without sufficient energy availability, you will not be able to run well. In particular, carbohydrates are vital for energy. Consume them sensibly and with fiber and proteins and fats rather than alone, but do consume them.
    4. Incorporate strength training! Your run is not “leg day” by itself. Furthermore, do whole-body strength training, to prevent injuries and improve overall performance. A strong core is particularly important.

    For more on each of these (and some bonus comments about mobility training for runners), enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • All About Olive Oil
  • Three Daily Servings of Beans?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Not crazy about the Dr.s food advice. Beans 3X a day?❞

    For reference, this is in response to our recent article on the topic of 12 things to aim to get a certain amount of each day:

    Dr. Greger’s Daily Dozen

    So, there are a couple of things to look at here:

    Firstly, don’t worry, it’s a guideline and an aim. If you don’t hit it on a given day, there is always tomorrow. It’s just good to know what one is aiming for, because without knowing that, achieving it will be a lot less likely!

    Secondly, the beans/legumes/pulses category says three servings, but the example serving sizes are quite small, e.g. ½ cup cooked beans, or ¼ cup hummus. And also as you notice, dips/pastes/sauces made from beans count too. So given the portion sizes, you could easily get two servings in by breakfast (and two servings of whole grains, too) if you enjoy frijoles refritos, for example. Many of the recipes we share on this site have “stealth” beans/legumes/pulses in this fashion

    Take care!

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  • What’s the difference between shyness and social anxiety?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

    The terms “shyness” and “social anxiety” are often used interchangeably because they both involve feeling uncomfortable in social situations.

    However, feeling shy, or having a shy personality, is not the same as experiencing social anxiety (short for “social anxiety disorder”).

    Here are some of the similarities and differences, and what the distinction means.

    pathdoc/Shutterstock

    How are they similar?

    It can be normal to feel nervous or even stressed in new social situations or when interacting with new people. And everyone differs in how comfortable they feel when interacting with others.

    For people who are shy or socially anxious, social situations can be very uncomfortable, stressful or even threatening. There can be a strong desire to avoid these situations.

    People who are shy or socially anxious may respond with “flight” (by withdrawing from the situation or avoiding it entirely), “freeze” (by detaching themselves or feeling disconnected from their body), or “fawn” (by trying to appease or placate others).

    A complex interaction of biological and environmental factors is also thought to influence the development of shyness and social anxiety.

    For example, both shy children and adults with social anxiety have neural circuits that respond strongly to stressful social situations, such as being excluded or left out.

    People who are shy or socially anxious commonly report physical symptoms of stress in certain situations, or even when anticipating them. These include sweating, blushing, trembling, an increased heart rate or hyperventilation.

    How are they different?

    Social anxiety is a diagnosable mental health condition and is an example of an anxiety disorder.

    For people who struggle with social anxiety, social situations – including social interactions, being observed and performing in front of others – trigger intense fear or anxiety about being judged, criticised or rejected.

    To be diagnosed with social anxiety disorder, social anxiety needs to be persistent (lasting more than six months) and have a significant negative impact on important areas of life such as work, school, relationships, and identity or sense of self.

    Many adults with social anxiety report feeling shy, timid and lacking in confidence when they were a child. However, not all shy children go on to develop social anxiety. Also, feeling shy does not necessarily mean a person meets the criteria for social anxiety disorder.

    People vary in how shy or outgoing they are, depending on where they are, who they are with and how comfortable they feel in the situation. This is particularly true for children, who sometimes appear reserved and shy with strangers and peers, and outgoing with known and trusted adults.

    Individual differences in temperament, personality traits, early childhood experiences, family upbringing and environment, and parenting style, can also influence the extent to which people feel shy across social situations.

    Shy child hiding behind tree
    Not all shy children go on to develop social anxiety. 249 Anurak/Shutterstock

    However, people with social anxiety have overwhelming fears about embarrassing themselves or being negatively judged by others; they experience these fears consistently and across multiple social situations.

    The intensity of this fear or anxiety often leads people to avoid situations. If avoiding a situation is not possible, they may engage in safety behaviours, such as looking at their phone, wearing sunglasses or rehearsing conversation topics.

    The effect social anxiety can have on a person’s life can be far-reaching. It may include low self-esteem, breakdown of friendships or romantic relationships, difficulties pursuing and progressing in a career, and dropping out of study.

    The impact this has on a person’s ability to lead a meaningful and fulfilling life, and the distress this causes, differentiates social anxiety from shyness.

    Children can show similar signs or symptoms of social anxiety to adults. But they may also feel upset and teary, irritable, have temper tantrums, cling to their parents, or refuse to speak in certain situations.

    If left untreated, social anxiety can set children and young people up for a future of missed opportunities, so early intervention is key. With professional and parental support, patience and guidance, children can be taught strategies to overcome social anxiety.

    Why does the distinction matter?

    Social anxiety disorder is a mental health condition that persists for people who do not receive adequate support or treatment.

    Without treatment, it can lead to difficulties in education and at work, and in developing meaningful relationships.

    Receiving a diagnosis of social anxiety disorder can be validating for some people as it recognises the level of distress and that its impact is more intense than shyness.

    A diagnosis can also be an important first step in accessing appropriate, evidence-based treatment.

    Different people have different support needs. However, clinical practice guidelines recommend cognitive-behavioural therapy (a kind of psychological therapy that teaches people practical coping skills). This is often used with exposure therapy (a kind of psychological therapy that helps people face their fears by breaking them down into a series of step-by-step activities). This combination is effective in-person, online and in brief treatments.

    Man working at home with laptop open on lap
    Treatment is available online as well as in-person. ImYanis/Shutterstock

    For more support or further reading

    Online resources about social anxiety include:

    We thank the Black Dog Institute Lived Experience Advisory Network members for providing feedback and input for this article and our research.

    Kayla Steele, Postdoctoral research fellow and clinical psychologist, UNSW Sydney and Jill Newby, Professor, NHMRC Emerging Leader & Clinical Psychologist, UNSW Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Hope: A research-based explainer

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    This year, more than 60 countries, representing more than 4 billion people, will hold major elections. News headlines already are reporting that voters are hanging on to hope. When things get tough or don’t go our way, we’re told to hang on to hope. HOPE was the only word printed on President Barack Obama’s iconic campaign poster in 2008.

    Research on hope has flourished only in recent decades. There’s now a growing recognition that hope has a role in physical, social, and mental health outcomes, including promoting resilience. As we embark on a challenging year of news, it’s important for journalists to learn about hope.

    So what is hope? And what does the research say about it?

    Merriam-Webster defines hope as a “desire accompanied by expectation of or belief in fulfillment.” This definition highlights the two basic dimensions of hope: a desire and a belief in the possibility of attaining that desire.

    Hope is not Pollyannaish optimism, writes psychologist Everett Worthington in a 2020 article for The Conversation. “Instead, hope is a motivation to persevere toward a goal or end state, even if we’re skeptical that a positive outcome is likely.”

    There are several scientific theories about hope.

    One of the first, and most well-known, theories on hope was introduced in 1991 by American psychologist Charles R. Snyder.

    In a paper published in the Journal of Personality and Social Psychology, Snyder defined hope as a cognitive trait centered on the pursuit of goals and built on two components: a sense of agency in achieving a goal, and a perceived ability to create pathways to achieve that goal. He defined hope as something individualistic.

    Snyder also introduced the Hope Scale, which continues to be used today, as a way to measure hope. He suggested that some people have higher levels of hope than others and there seem to be benefits to being more hopeful.

    “For example, we would expect that higher as compared with lower hope people are more likely to have a healthy lifestyle, to avoid life crises, and to cope better with stressors when they are encountered,” they write.

    Others have suggested broader definitions.

    In 1992, Kaye Herth, a professor of nursing and a scholar on hope, defined hope as “a multidimensional dynamic life force characterized by a confident yet uncertain expectation of achieving good, which to the hoping person, is realistically possible and personally significant.” Herth also developed the Herth Hope Index, which is used in various settings, including clinical practice and research.

    More recently, others have offered an even broader definition of hope.

    Anthony Scioli, a clinical psychologist and author of several books on hope, defines hope “as an emotion with spiritual dimensions,” in a 2023 review published in Current Opinion in Psychology. “Hope is best viewed as an ameliorating emotion, designed to fill the liminal space between need and reality.”

    Hope is also nuanced.

    “Our hopes may be active or passive, patient or critical, private or collective, grounded in the evidence or resolute in spite of it, socially conservative or socially transformative,” writes Darren Webb in a 2007 study published in History of the Human Sciences. “We all hope, but we experience this most human of all mental feelings in a variety of modes.”

    To be sure, a few studies have shown that hope can have negative outcomes in certain populations and situations. For example, one study highlighted in the research roundup below finds that Black college students who had higher levels of hope experienced more stress due to racial discrimination compared with Black students who had lower levels of hope.

    Today, hope is one of the most well-studied constructs within the field of positive psychology, according to the journal Current Opinion in Psychology, which dedicated its August 2023 issue to the subject. (Positive psychology is a branch of psychology focused on characters and behaviors that allow people to flourish.)

    We’ve gathered several studies below to help you think more deeply about hope and recognize its role in your everyday lives.

    Research roundup

    The Role of Hope in Subsequent Health and Well-Being For Older Adults: An Outcome-Wide Longitudinal Approach
    Katelyn N.G. Long, et al. Global Epidemiology, November 2020.

    The study: To explore the potential public health implications of hope, researchers examine the relationship between hope and physical, behavioral and psychosocial outcomes in 12,998 older adults in the U.S. with a mean age of 66.

    Researchers note that most investigations on hope have focused on psychological and social well-being outcomes and less attention has been paid to its impact on physical and behavioral health, particularly among older adults.

    The findings: Results show a positive association between an increased sense of hope and a variety of behavioral and psychosocial outcomes, such as fewer sleep problems, more physical activity, optimism and satisfaction with life. However, there wasn’t a clear association between hope and all physical health outcomes. For instance, hope was associated with a reduced number of chronic conditions, but not with stroke, diabetes and hypertension.

    The takeaway: “The later stages of life are often defined by loss: the loss of health, loved ones, social support networks, independence, and (eventually) loss of life itself,” the authors write. “Our results suggest that standard public health promotion activities, which often focus solely on physical health, might be expanded to include a wider range of factors that may lead to gains in hope. For example, alongside community-based health and nutrition programs aimed at reducing chronic conditions like hypertension, programs that help strengthen marital relations (e.g., closeness with a spouse), provide opportunities to volunteer, help lower anxiety, or increase connection with friends may potentially increase levels of hope, which in turn, may improve levels of health and well-being in a variety of domains.”

    Associated Factors of Hope in Cancer Patients During Treatment: A Systematic Literature Review
    Corine Nierop-van Baalen, Maria Grypdonck, Ann van Hecke and Sofie Verhaeghe. Journal of Advanced Nursing, March 2020.

    The study: The authors review 33 studies, written in English or Dutch and published in the past decade, on the relationship between hope and the quality of life and well-being of patients with cancer. Studies have shown that many cancer patients respond to their diagnosis by nurturing hope, while many health professionals feel uneasy when patients’ hopes go far beyond their prognosis, the authors write.

    The findings: Quality of life, social support and spiritual well-being were positively associated with hope, as measured with various scales. Whereas symptoms, psychological distress and depression had a negative association with hope. Hope didn’t seem to be affected by the type or stage of cancer or the patient’s demographics.

    The takeaway: “Hope seems to be a process that is determined by a person’s inner being rather than influenced from the outside,” the authors write. “These factors are typically given meaning by the patients themselves. Social support, for example, is not about how many patients experience support, but that this support has real meaning for them.”

    Characterizing Hope: An Interdisciplinary Overview of the Characteristics of Hope
    Emma Pleeging, Job van Exel and Martijn Burger. Applied Research in Quality of Life, September 2021.

    The study: This systematic review provides an overview of the concept of hope based on 66 academic papers in ten academic fields, including economics and business studies, environmental studies, health studies, history, humanities, philosophy, political science, psychology, social science, theology and youth studies, resulting in seven themes and 41 sub-themes.

    The findings: The authors boil down their findings to seven components: internal and external sources, the individual and social experience of hope, internal and external effects, and the object of hope, which can be “just about anything we can imagine,” the authors write.

    The takeaway: “An important implication of these results lies in the way hope is measured in applied and scientific research,” researchers write. “When measuring hope or developing instruments to measure it, researchers could be well-advised to take note of the broader understanding of the topic, to prevent that important characteristics might be overlooked.”

    Revisiting the Paradox of Hope: The Role of Discrimination Among First-Year Black College Students
    Ryon C. McDermott, et al. Journal of Counseling Psychology, March 2020.

    The study: Researchers examine the moderating effects of hope on the association between experiencing racial discrimination, stress and academic well-being among 203 first-year U.S. Black college students. They build on a small body of evidence that suggests high levels of hope might have a negative effect on Black college students who experience racial discrimination.

    The authors use data gathered as part of an annual paper-and-pencil survey of first-year college students at a university on the Gulf Coast, which the study doesn’t identify.

    The findings: Researchers find that Black students who had higher levels of hope experienced more stress due to racial discrimination compared with students who had lower levels of hope. On the other hand, Black students with low levels of hope may be less likely to experience stress when they encounter discrimination.

    Meanwhile, Black students who had high levels of hope were more successful in academic integration — which researchers define as satisfaction with and integration into the academic aspects of college life — despite facing discrimination. But low levels of hope had a negative impact on students’ academic well-being.

    “The present study found evidence that a core construct in positive psychology, hope, may not always protect Black students from experiencing the psychological sting of discrimination, but it was still beneficial to their academic well-being,” the authors write.

    The takeaway: “Our findings also highlight an urgent need to reduce discrimination on college campuses,” the researchers write. “Reducing discrimination could help Black students (and other racial minorities) avoid additional stress, as well as help them realize the full psychological and academic benefits of having high levels of hope.”

    Additional reading

    Hope Across Cultural Groups Lisa M. Edwards and Kat McConnell. Current Opinion in Psychology, February 2023.

    The Psychology of Hope: A Diagnostic and Prescriptive Account Anthony Scioli. “Historical and Multidisciplinary Perspectives on Hope,” July 2020.

    Hope Theory: Rainbows in the Mind C.R. Snyder. Psychological Inquiry, 2002

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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