About a decade ago, disillusioned with her medical school training and mainstream medicine, and traumatized by the death of a patient, Pooja Lakshmin did the unthinkable: she blew up her marriage, dropped out of her highly competitive residency program and moved into a wellness commune that practiced orgasmic meditation. It was major. Though she extricated herself from the group two years later, the experience, and the hard-won lesson that no external, shiny wellness practice could fix her problems, were invaluable as she returned to medical training.

Today, Lakshmin specializes in women’s mental health, and in her active practice she helps women and people from marginalized communities who struggle with burnout, despair, depression, and anxiety. Part of her work is to help her patients identify faux self-care practices, ones that “keep us looking outward—comparing ourselves with others or striving for a certain type of perfection—which means it’s incapable of truly nourishing us in the long run.” Instead, she advocates for real self-care, which is “an internal process that involves making difficult decisions that will pay off tenfold in the long run as a life built around the relationships and activities that matter most to you.” Here, she offers guidance on how to distinguish between the two.

As a psychiatrist, I’m understandably interested in the connection between the explosion of faux self-care and the status of mental health treatment. While not everyone who engages with faux self-care needs professional mental health services, the symptoms of a major depressive disorder or a clinical anxiety disorder have quite a bit of overlap with those of burnout and chronic stress. But mental health treatment (like seeing a psychotherapist or a psychiatrist) is financially costly and typically not covered by insurance, and so remains inaccessible to many. It also takes time. The work of psychotherapy is not instantaneous—it can take months to see some progress (or to even get off a waiting list to be seen!). Similarly, trying to find the right medication can also take time. On the other hand, the seemingly easy and shiny solutions of faux self-care are, well, so much more simple and sexy. Why fight with your insurance company when you can buy a vitamin pack that your favourite influencer recommends, and it will be delivered to your door the next day?

So we can’t talk about faux self-care without talking about mental health treatment. We also can’t talk about any of this without acknowledging there is a huge gap in access to affordable mental health services. There are several parts to the interplay between mental health and wellness solutions—first, a lack of education and awareness for many women about what constitutes a clinical mental health condition. Then, there’s the stigma that still exists around seeing a therapist or a psychiatrist. Finally, once you’ve crossed all of those not-insignificant hurdles, there is the lack of insurance coverage, and the fact that finding access to a good therapist and psychiatrist is still only possible for the most privileged in our society. It’s in this context, where actual treatment for mental health conditions is inaccessible for the vast majority of folks, that our culture serves us faux self-care as a quick fix and as a poor substitute for professional help. I don’t mean to shame anyone here—in fact, when you are clinically depressed or anxious, finding a therapist and calling up your insurance company is even more difficult. It’s no wonder that we are vulnerable to the slick marketing of faux self-care. The time has come for self-care to evolve again, to take on a new definition. And that definition requires looking deeper, turning inward, and developing a reliable internal method for yourself—not one that has been prescribed for you by a wellness company or an influencer, but instead a solution that comes from you.

I know that some of you might enjoy and look forward to wellness practices—like yoga, meditation, or energy work. I’m not here to shame any of you who like to turn to wellness activities. In fact, in the years since I left the cult, I’ve been known to indulge in a Reiki session or two, even while writing this book! This might sound confusing to you, because the premise of the solution I’m proposing is seemingly counter to commodified wellness and so-called woowoo practices. Hear me out—one person’s yoga class can be profoundly nourishing, while another person’s yoga class can simply be an avoidance strategy or an escape. Like we just discussed, there are an infinite number of methods you can use to take care of yourself—my goal here is to offer you the guiding principles that you can implement to uncover your own unique methods. Real self-care is not a noun, it’s a verb. So it’s possible for the work of real self-care (boundary setting, self-compassion, and getting clear on values) to point you in the direction of a wellness activity. For example, if you have a hard conversation with your partner about needing space in your week for your yoga class and go on to treat yourself kindly during that yoga class and reflect explicitly about how a yoga practice is in alignment with your values, this is real self-care! The internal work that gets you to the yoga class is the bit that carries forth sustainably and reliably—perhaps in some seasons of your life the method will be yoga, and in other seasons the method will be different. The internal process—real self-care—is timeless.

When you first start out, it can be a little tricky to differentiate between faux self-care and real self-care. The following chart can help you spot the difference.

Faux Self-Care	Real Self Care
Prescribed from outside	Originates within you
A noun, typically describing an activity or a product	A verb, describing an invisible, internal decision-making process
Common examples: a yoga class, a meditation app, or a fancy face cream	The internal process that goes on for you before you make the choice to attend the yoga class, listen to the meditation app, or put on the fancy face cream
Maintains status quo in your relationship or family, and does nothing to change larger systems	Allows you to get your needs met in your relationships, and can effect change in your family, workplace, and larger systems
Often leaves you feeling further away from yourself	Brings you closer to yourself and what’s most important to you
Typically comes with feelings of guilt (either for never getting to it, or while you are engaging in it because you are neglecting other responsibilities)	Requires learning to cope with feelings of guilt as part of the process
Allows you to avoid or brush aside emotional costs or risks	Comes with a short-term emotional cost, in order to reap longer-term emotional gains

 

Now that you’re getting a better sense of the difference between real self-care and faux self-care, consider the following questions: What types of faux self-care have you tried? When do you find yourself most likely to turn to faux self-care? What aspect of faux self-care has you feeling the most disappointed? Have there been certain activities or wellness practices that have helped you? Are there certain feelings or thoughts about yourself that these activities elicit? In order to integrate these helpful wellness activities into your life, have you noticed changes in how you talk to yourself or how you navigate your relationships? If so, what changes have you noticed? Come back to these questions to distinguish for yourself which activities fall into the faux self-care category and which are aligned with real self-care. Over time, asking yourself these questions will feel second nature.

Adapted from Real Self-Care by Pooja Lakshmin, MD. Copyright © 2023 by Pooja Lakshmin. Published by arrangement with Penguin Life, an imprint of Penguin Publishing Group/Random House/The Knopf Doubleday Group, a division of Penguin Random House LLC. 

Next: “For Me, Self-Care Is Self-Compassion”

This tart is the dessert equivalent of the movie The Notebook. It seems basic on the surface, but if you look deeper, you’ll find yourself an instant classic that’s impossible to resist.

Nutty Chocolate Ganache Tart

Makes 1 ( 12-inch ) tart

Special Equipment

• 12-inch removable-bottom tart pan
• Food processor

Ingredients

Crust

• 3 cups mixed raw nuts (we like walnuts, blanched hazelnuts, pistachios and almonds)
• 7 tbsp brown sugar
• ¾ tsp kosher salt
• 5 tbsp unsalted butter, melted

Ganache

• 14 oz (400 g) bittersweet chocolate, chopped
• 2 cups 35% cream
• 7 tbsp unsalted butter, room temperature, cut into 1-inch cubes

Serving

• Flaky sea salt

Directions

Preheat the oven and prepare the pan: Place a rack in the middle of the oven and preheat to 350°F. Lightly butter a 12-inch removable-bottom tart pan and line the bottom with a round of parchment paper.

Make the crust: Add the nuts to a food processor and pulse until finely chopped. Add the sugar and salt and pulse again to com- bine. Drizzle in the melted butter and pulse until the nuts begin to clump together and the mixture looks sandy. Transfer the mixture to the pan and use your hands to firmly and evenly press it into the bottom and up the sides of the pan (it doesn’t need to come all the way up the sides). Bake the crust until it turns golden brown, about 15–20 minutes. Set aside to cool.

Make the ganache: Place the chocolate in a medium bowl. In a small pot, heat the cream until it’s just beginning to simmer.

Immediately pour it over the chocolate and let it sit, undisturbed, for 5 minutes. Add the butter and mix with a spatula until the mix- ture becomes smooth and glossy.

Assemble and chill: Pour the ganache into the crust and, using an offset spatula, smooth out any bubbles. Chill in the fridge, uncovered, until set, at least 1 hour.

Serve: Remove the tart from the pan and transfer to a plate. Sprinkle the top with flaky sea salt. Slice the tart into wedges with a hot knife for a clean cut. The tart can be made 1 day ahead and stored, covered, in the fridge.

Excerpted from Salad Pizza Wine by Janice Tiefenbach, Stephanie Mercier Voyer, Ryan Gray and Marley Sniatowsky. Copyright © 2023 Janice Tiefenbach, Stephanie Mercier Voyer, Ryan Gray, and Marley Sniatowsky. Photographs by Dominique Lafond. Published by Appetite by Random House®, a division of Penguin Random House Canada Limited. Reproduced by arrangement with the Publisher. All rights reserved.

Next: This Potato-Topped Pizza Al Taglio Is the Ultimate Comfort Food

This recipe for pizza al taglio is made with potatoes—and it makes our knees weak and our hearts melt. Biting into a thick layer of rosemary-infused potatoes, cheese and dough feels like getting tucked into bed and kissed on the forehead by a loved one. It’s pure comfort.

Pizza Al Taglio

Makes 1 (12 × 15-inch)

Ingredients

Pizza Dough

• 6 1/3 cups (820 g) bread flour
• 1 1/3 cups (200 g) spelt or whole wheat flour
• 3 cups (750 ml) water, room temperature
• 1 cup (200 g) sourdough starter
• 5 tsp (25 g) fine sea salt
• 3 tbsp (45 ml) extra virgin olive oil, divided, + more oil or butter for greasing the baking sheets
• Semolina rimacinata or all-purpose flour, to dust your work surface

Pizza

• 1/2 recipe Al Taglio Pizza Dough (enough for one pizza)
• 1 lb (450 g) fingerling potatoes or 2 large Yukon gold potatoes, scrubbed
• 6 fresh rosemary sprigs (2 whole and 4 chopped), divided
• 1 tsp black peppercorns
• Extra virgin olive oil
• 5 oz (142 g) smoked provolone or smoked cheddar, sliced
• 2 balls (5.2 oz/150 g or about 1 cup) buffalo mozzarella
• 1 small yellow onion, thinly sliced (about 1 cup)
• Freshly ground black pepper 1 cup finely grated parmesan

Directions

Pizza Dough

hydrate the flours: In the bowl of a stand mixer with a hook attachment (or in a very large bowl using a rubber spatula), com- bine the flours with the water. Mix on the lowest setting until a shaggy mass forms. Turn off the mixer and let it rest for 10 minutes.

Mix or knead the dough: Add the sourdough starter and salt and continue to knead until the dough is smooth and relatively uniform, about 10 minutes. Transfer the dough to a clean surface and scrape out the mixing bowl using a dough scraper, discard- ing any dried bits. Generously oil that same bowl with 2 tbsp olive oil and place the dough inside. Cover the dough and rest it at room temperature for 30 minutes.

Fold the dough and let it rise: Starting with the edge farthest away from you, gently lift and fold the dough in half over itself. (This motion should be done confidently to stretch the dough without ever tearing it.) Rotate the bowl 90 degrees and repeat the same process until the dough has been folded on itself for a total of four times, rotating the bowl after each fold. Cover the dough and rest it at room temperature for 30 minutes. Repeat the folding process two more times, resting the dough 30 minutes at the end of each folding session. The whole process should take about 1½ hours.

Divide the dough: Transfer the dough to a lightly floured surface by flipping the bowl over and letting the dough slowly fall out.
Using a dough scraper, divide the dough in half.

Corner toward the center of the dough. Then fold the dough on itself twice as if you were folding a piece of paper to put in an envelope. Use the dough scraper to tuck the edges and create a smooth and even oval shape. Put the dough back in the same oiled container.
Cover and chill in the fridge for 2 days. During this time, the dough should proof gently, becoming lighter and springier to the touch.
It can be stored in a lightly oiled, sealed container in the fridge for up to 3 days or frozen for a few months.

When you are ready to make your pizza, proof the dough again: Grease two baking sheets with olive oil (or use butter for an extra-crispy bottom crust). Uncover the dough and coat lightly with 1 tbsp olive oil. Carefully transfer each dough portion onto the baking sheets, keeping the top side of the proofed dough facing up. Using your fingertips, gently press down on the surface of the dough to release some of the air. Cover with a damp towel and let it rest in a warm spot for at least 30 minutes and up to 3 hours. (The longer the dough proofs, the more relaxed it will become, making it easier to stretch but also more fragile.)

Stretch the dough: Once the dough has proofed, uncover it and start stretching it by lifting it from the bottom to make sure no air gets trapped underneath. Gradually and gently stretch out the corners of the dough toward the edges of the baking sheet.

Continue working with your fingertips to stretch the dough until it’s about the same size as the baking sheet. Press the dough firmly into the corners. Repeat this process with the remaining portion of dough. Your al taglio is now ready to welcome toppings.

Pizza

Temper the dough: If your dough is in the fridge, remove it and let it temper while you cook the potatoes. If it’s still proofing on the counter, leave it there.

Cook the potatoes: Bring a pot of salted water to a boil. Add the potatoes, two rosemary sprigs and the peppercorns and simmer until the potatoes are fork-tender but not falling apart, 20 minutes for fingerlings and 25–35 for larger potatoes. Remove the potatoes from the pot and let them rest for a few minutes.

Once they are cool enough to handle but still warm, peel the skins off using a small paring knife. Put the potatoes in a bowl and break them into rough chunks. Add 2 tbsp olive oil and toss to coat.

Preheat the oven: Place a rack in the upper and lower thirds of the oven. Preheat the oven to 500°F.

Stretch the dough: Once your dough is done proofing and you are ready to make your pizza, stretch it as directed in the al taglio dough recipe (p. 104 or 106).

Top the pizza: Distribute the provolone on the pizza, reaching as close to the edges as possible. Break the buffalo mozzarella into small pieces and disperse evenly. Top with the crushed potatoes, sliced onions and chopped rosemary.

Bake the pizza: Place the pizza on the bottom rack, moving it to the top halfway through, and bake until the crust is golden brown and the onions are charred in spots, 12–15 minutes.

Finish the pizza and serve: Garnish with more olive oil, freshly ground black pepper and freshly grated parmesan. Cut into squares and enjoy!

Excerpted from Salad Pizza Wine by Janice Tiefenbach, Stephanie Mercier Voyer, Ryan Gray and Marley Sniatowsky. Copyright © 2023 Janice Tiefenbach, Stephanie Mercier Voyer, Ryan Gray, and Marley Sniatowsky. Photographs by Dominique Lafond. Published by Appetite by Random House®, a division of Penguin Random House Canada Limited. Reproduced by arrangement with the Publisher. All rights reserved.

Next: Shake Up Pizza Night with this Riff on the Classic “Grandma Slice”

About a year and a half into the pandemic, 39-year-old stay-at-home mom of two Karen Whaley picked up a buzzy romance novel and zipped through all 300-plus pages in one evening. It was an unusual experience for her.

Whaley had been stuck in an all-too-familiar cycle: “I was doomscrolling all the time,” she says. “I had also totally lost my ability to focus on anything—I wasn’t reading books or watching TV. I couldn’t even bring myself to start.” But after hearing about The Hating Game by Sally Thorne on a podcast and being intrigued by its workplace-drama plot, Whaley downloaded the e-book—and then couldn’t set it aside. The sudden voraciousness for reading surprised her—she’d never been into romance books. In fact, she had thought she was “too good” for the genre. But while reading The Hating Game, Whaley realized it was fascinating to delve into the lives of women who were very different from her. After finishing the book, Whaley tore through 20 more romances in three months. “It opened me up to reading other genres. I was somehow getting my focus back.”

Turns out, many people found themselves revelling in steamy romance books during the pandemic. Romance fiction sales in Canada saw a 44 percent increase from June 2020 to June 2021, thanks in part to TikTok. In the first few months of 2023, the popular hashtag #BookTok, where readers share their recommendations and reviews, had passed 115 billion views. Most videos on #BookTok feature a reader who raves about a novel, often getting emotional. The intimate and honest tone of the videos encourages viewers to buy the book, leading to a massive boost in sales.

It’s word-of-mouth marketing cranked to a hundred: One viral video can garner millions of views—and sales. Rania Husseini, senior vice president of print at Indigo, Canada’s largest bookstore, says the chain has seen “an extraordinary surge in demand for books thanks to BookTok.” Picks from “Spicy BookTok,” the online community that’s gathered around sexually explicit romance novels, “have gained significant traction over the past two years” in particular, notes Husseini. From 2020 to 2022, the total unit sales of books at Indigo categorized under Spicy BookTok rose 3,104 percent. And despite their trendy-looking covers, these books don’t differ significantly from the bodice rippers of yesteryear (you know, the ones with Fabio on the cover). They’re still romance novels with fairly predictable plots involving two people (usually a man and a woman) falling in love and having outrageous sex. Plus, tropes that are common to BookTok favourites—like haters-to-lovers or second-chance romances—are the same ones that have been well-loved in Harlequin romances and romantic comedies for as long as the genres have existed.

Jenny Pool, owner of Happily Ever Books— Canada’s only romance-focused online bookstore—has heard from many readers who say they’ve turned to romance over the last couple of years because the books provide an escape. It’s the emotional interplay between a couple that draws people in, rather than any intricate plot, says Pool. “It’s not about the destination, what happens at the end of the book. It’s the journey that two or more characters go on—that’s what we’re interested in, that’s what the best part of a romance is. It’s getting to explore different dynamics.”

But the sexy content is a draw, too. Hanna Wheeler, a 41-year-old writer and translator in Toronto, says that other people’s desire is what draws her to these books. “It’s an inspiration, having these really open conversations about sexuality and turn-ons,” she says. The sexual content provides her with tools on how to initiate conversations about sex and relationships in her own life—especially those books with a lightheartedness in how characters approach their love life.

In addition to the escapism, readers can also be turned on by romance novels, says Jan Cioe, a registered psychologist and an associate professor of psychology at the University of British Columbia. For some, the books “can provide an idea of something new and different,” he explains. He echoes Wheeler’s notion that risqué reads can be a sort of inspiration. “Typically, most women—but certainly not all—need some kind of nurturing towards [sex],” Cioe says, “and that can happen in the context of reading these novels, because they create sexual arousal that can then be manifested in a physical encounter.”

(Related: Are Your Sexual Fantasies Normal?)

However, Cioe points out, trouble can arise when readers take their favourite novel’s content as reality. Some BookTok bestsellers, like Colleen Hoover’s It Ends with Us, depict rough and violent sexual encounters and toxic (usually male) love interests, which some critics say can romanticize unhealthy relationships. Rough sex is not inherently negative, but it shouldn’t be idealized or depicted as the best or only kind of sex, and expressing consent is key (something many of the books gloss over). “Unfortunately, in our culture, there’s pressure for women to…placate their partner,” says Cioe. Many romance novels are written by women with female pleasure in mind, but they are designed to be entertainment—not education. Conflating the sometimes extreme sexual content in a book with what you—or your partners—might want in real life can lead to unhealthy relationship dynamics. To prevent that, it’s important to know your own comfort zones. “Optimal sexual encounters are grounded in clear lines of communication,” says Cioe.

Pool notes that these reads give people the opportunity to explore situations safely—whether it’s a sweeping love story or a short-lived affair. “And, you know that it’s all going to work out okay in the end. It gives a little bit of relief, and you can really enjoy the journey the characters go on,” she says. “You know that there’ll be a happily ever after.”

Hot in Here

Find your happily ever after with these popular-on-#BookTok titles—all available at Indigo or your fave indie bookstore like Happily Ever Books.

The Kiss Quotient by Helen Hoang
This debut novel follows Stella, a math whiz who has done a lot less dating than the average thirtysomething. She hires a male escort to practice everything from kissing to more-than-missionary position. $22, chapters.indigo.ca

Neon Gods by Katee Robert
Inspired by Greek mythology, Neon Gods is a racy modern-day adaptation of the story of Persephone and Hades. $23, chapters.indigo.ca 

Get a Life, Chloe Brown by Talia Hibbert
This rompy novel from British author Talia Hibbert is about a woman who’s tired of being “boring”—so she recruits her neighbour to help her experience things like getting drunk and casual sex. $21, chapters.indigo.ca

Book Lovers by Emily Henry
This novel by a favourite BookTok author revolves around a cutthroat New York literary agent and a brooding book editor who have a contemptuous relationship. $23, chapters.indigo.ca

Love and Other Words by Christina Lauren
This sultry read follows a rigid medical resident who thinks her life path is set—until she runs into her first (and only) love. $23, chapters.indigo.ca

It Happened One Summer by Tessa Bailey
This spicy read follows a fashionable It girl who’s suddenly sent away to spend the summer running her late father’s dive bar in rainy Washington State. She soon meets bearded sea captain Brendan, her polar opposite, with whom she has a fiery connection. $20, chapters.indigo.ca 

The Wall of Winnipeg and Me by Mariana Zapata
After the assistant-slash-housekeeper to a famous football player quits her job, she’s shocked when he begs her to come back…and do something unthinkable. $25, chapters.indigo.ca

The Hating Game by Sally Thorne
Lucy and Joshua, two executive assistants to a pair of co-CEOs, are up for the same promotion, and the tension is reaching a boiling point. $20, chapters.indigo.ca

Twisted Games by Ana Huang
This is the second book in the Twisted series, which follows the forbidden (and steamy) relationship of a stoic bodyguard and a stubborn princess. $27, chapters.indigo.ca

Next: 18 Goodies That’ll Help Turn Up the Heat in the Bedroom

University Avenue in Toronto is lined with several major hospitals, but nestled inside one of them—University Health Network’s Toronto Rehabilitation Institute—is a fully functioning apartment, plopped right there on the twelfth floor amid a sea of standard office cubicles.

The one-bedroom apartment has no ceilings, and is lined with cameras, “domestic robots” and motion-sensing detectors designed to keep residents safe as they age, recover from stroke or seek to live independently with a disability or dementia (for example). The “home within a lab” is also designed to replicate the same accessibility challenges that seniors and their caregivers would encounter in a typical home, so researchers can test out creative solutions to common barriers.

Yes, it’s all a bit Big Brother-y, but the catwalk, the robot and the video cameras are there in the name of science. This is where Atena Roshan Fekr and her team of grad students at the KITE Research Institute HomeLab test out new products, design artificial intelligence data programs and build prototypes aimed at helping the 92 percent of Canadians aged 45-plus who would prefer to age in place, as opposed to living in a long-term care facility, according to a 2022 Ipsos poll.

Roshan Fekr specializes in the intersection of technology and aging. The KITE HomeLab is one of four institutions across Canada that make up a project called PATH: the Program to Accelerate Technologies for Home Care. Roshan Fekr and her colleagues develop and test these remote monitoring systems so that they can, one day, be successfully commercialized.

The data gathered will also be super valuable to doctors, and busy or far-away relatives and caregivers trying to get a sense of how their loved one is doing on their own. “The clinician or the family members will be notified if there’s a problem, or if they are progressing,” says Roshan Fekr. Here are some of the apartment’s features that can help keep seniors safe.

(Related: 5 of the Best Exercise Bikes for Seniors)

Cameras or catwalk

From the catwalk, and using the video camera footage, researchers can observe volunteer actors who imitate the typical behaviours, movements and reactions of those with physical disabilities or “sensory and cognitive impairments” as they interact with a standard residential space.

Helpful robot

This “domestic robot” gives both audio and video prompts to “people with dementia during their common everyday tasks, like washing their hands, brushing their teeth, or making a cup of tea,” says scientist Alex Mihailidis. It uses artificial intelligence to adapt to the needs of the individual user.

Smart sheets

The mat on the bed measures health data such as heart rate and respiration rate, says Roshan Fekr. It can also monitor sleeping position and can alert a caregiver that it’s time to help turn the patient to prevent pressure sores (aka bed sores).

Grab bars

Standard accessibility grab bars help seniors navigate safely from the bedroom to the bathroom especially at night, when visibility and mental alertness may be limited.

Bathroom monitoring

Roshan Fekr and her colleagues will soon be testing a device that tracks toilet use and measures a resident’s level of hydration and output.

Exercise mat

This smart yoga mat is used to record physical therapy sessions. Tele-rehab allows seniors to recover at home (from a hip replacement or a stroke, for example) without needing to drive or commute to a hospital or PT office as an outpatient. The camera over the TV monitors body alignment, and the pressure heat as a patient does exercises on the fitness mat also creates data points.

Smart garment

This wearable, washable shirt from Hexoskin can measure vital signs such as heart rate, breathing rate and the resident’s ECG (or electrocardiogram, which can monitor heart conditions), as well as general activity like total daily steps and calories burned.

Outlet plugs

Remote users (such as a family member) can turn off an appliance that’s been accidentally left on (using Wi-Fi and a phone app). They can also monitor activity levels around the apartment by detecting what’s plugged in where and for how long.

Drawer, oven, microwave and fridge sensors

The kitchen drawers, cupboards, microwave, oven and refrigerator are equipped with door contact sensors that track when a resident is opening and closing them. This gathers data that can be helpful to families worried their loved one isn’t eating or drinking enough—or concerned about safety in the kitchen.

Living room floors

For a future project, the floors will be equipped with pressure sensors that can monitor a senior’s movement patterns and log changes to their gait (which is a possible sign of deteriorating health).

Next: 5 Stretching Exercises for Seniors—or Anyone Who Feels Achy

When a blemish appears on your skin, chances are you jump into repair mode. You examine it, review your arsenal of beauty products, and calculate the best treatment to clear it up immediately. You may even consider prevention tactics—analyzing your food diary to eliminate a potential trigger, or finally replacing that face mask—to ensure there are no reappearances. But then it returns. Why? Maybe you’re not treating the right thing. A new school of thought suggests that treating skin problems may have more to do with your mind.

What is psychodermatology?

“Original reports of the connection between the mind and the body have been around for hundreds of thousands of years, and we’re now rediscovering these connections,” says Mark Kirchhof, a certified dermatologist at Ottawa Derm Centre. The study of this relationship is called psychodermatology, which is the combination of psychiatry and dermatology. “It explores the interplay between the mind and the body—how skin diseases can affect the mind and how the mind can affect skin diseases,” says Kirchhof.

Recent interest in psychodermatology came from the finding that people who have skin diseases also typically have high levels of depression, anxiety and other psychiatric comorbidities. Researchers found that when those patients were treated for their skin disease, their psychiatric conditions improved. “Recently the reverse has been investigated—if we treat the mind, can the skin disease get better?” says Kirchhof. “That seems to be the case as well.”

How does psychodermatology work?

It comes down to the way the mind, the endocrine system, and the skin interact, says Kirchhof. Anxious thoughts, stressful situations, anger, and depression impact the nervous system. These thoughts can work their way from the brain, through the endocrine system, and show up on the face and body.

Skin conditions that can be caused by—and could cause—psychiatric conditions include psoriasis, eczema, hyperhidrosis, hives, cold sores and acne, says Kirchhof. How do you know when a skin condition has a psychiatric cause? A dermatologist can help with the assessment. “[Dermatologists] have lots of patients who are looking for alternative treatments, and we encourage them,” says Kirchhof. “If they don’t work, then we’re happy to add on treatments and prescription medications that can help.”

What are the treatments?

Treatment options vary from person to person. “Some conditions are more psychiatric and less dermatological and others are highly dermatological and less psychiatric,” says Kirchhof. The best form of treatment will depend on where the disease falls on this spectrum.

Studies show that if you treat the skin issues of people suffering from depression or anxiety, their symptoms will improve as well. For teenagers with severe acne and depression, Kirchhof will often treat the acne first. “Then, I’ll determine if their depression has resolved or if there’s still an underlying psychiatric disease that requires further treatment.”

Conversely, a recent study also showed those with depression or anxiety are at a higher risk of developing skin diseases such as psoriasis. The treatment? Taking antidepressants, which can protect against developing a skin disease. “Some of the medications and treatments that we might use in psychiatry may help in dermatology,” says Kirchhof, “and some of the treatments that we use in dermatology may help in psychiatry.”

If you suspect your mental health may be causing a particular skin condition, Kirchhof recommends first seeing a dermatologist and doing your research, then potentially reaching out to a psychiatrist. “Some psychiatrists may not be aware of these connections and may not entertain treating the psychiatric component to improve the skin disease,” he says. “Find a psychiatrist who is interested and willing to help in that regard.”

How much can stress impact your skin?

Stress, Kirchhof says, can impact skin diseases “tremendously.” It can cause skin disorders and also exacerbate current ones. “Studies show if you treat or lower stress, you can improve some skin conditions,” says Kirchhof. He often recommends treating both skin and psychiatric conditions with stress-reducing techniques, whether on their own or in conjunction with medication.

Studies show mindfulness, meditation, positive thinking, exercise, and cognitive behavioural therapy can have a positive impact on skin disease, says Kirchhof. “When we’re treating a severe skin disease, it appears that practicing mindfulness or meditation techniques make the treatments work better in those people than in groups that do not.”

So next time a mark or a flair-up appears, instead of jumping into repair mode, which will only increase your cortisol levels further, sink into relaxation mode. It might be just what the mark needs to heal—no pricey product necessary.

Next:This Unexpected Technique Can Help Control Anxiety

I wanted to create a mango-coconut dessert that’s faster to make than mango and sticky rice. One day, after seeing the tapioca-mango dessert cups that are always sold at my local Chinese supermarket, I got this idea. Tiny tapioca pearls are folded into a silky coconut cream and topped with fresh, juicy mango. It’s the same flavor combination as mango and sticky rice, yet a vastly different eating experience. Tapioca pearls lose their soft chewy texture after many hours in the fridge, so this isn’t something you want to make too far ahead, but they’re so quick that you can prep the coconut cream in advance and cook the pearls while people are digesting dinner!

But before we get to the recipe, a note about working with tapioca:  “My tapioca pearls turned into mush in the water!” This has been the cry of far too many people, and I know exactly what has happened when they tell me this. They add the tapioca to room temperature water and bring it to a boil, like you would do with rice. This is understandable, since tapioca pearls kind of remind you of rice, right? So I need to stress the number one rule when working with tapioca pearls: do not add them to anything other than fully boiling liquid.

This makes sense once you understand what tapioca pearls actually are: simply tapioca starch that has been clumped together into tiny balls, similar to the way old cornstarch can get clumpy in the bag. So, if you put them in not-hot-enough water, they will just dissolve. But when they go into boiling water, the outside instantly gels up, creating a shell that holds the inside together while it cooks through.

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Mango Coconut Tapioca Pudding

Pudding Sakoo Mamuang Sohd | พุดดิ้งสาคูมะม่วงสด

Serves 4 to 6
Cooking Time : 30 minutes

Ingredients

• 1 cup (250 ml) coconut milk
• 1 pandan leaf, tied into a knot (optional; see note below )
• 5 to 7 tablespoons (62 to 75 g) finely chopped palm or granulated sugar (see note)
• ¼ teaspoon (1 ml) table salt
• 2 tablespoons (15 g) rice flour
• 2 tablespoons (30 ml) water
• ½ cup (85 g) small tapioca pearls
• ½ cup (10 g) julienned young coconut meat, fresh or canned
• 2 to 3 sweet ripe mangoes, cut in ½-inch (1.2 cm) cubes

Directions

Bring at least 6 cups (1.5 L) water to a full boil over high heat to cook the tapioca pearls. Make the coconut cream by placing the coconut milk and pandan leaf in a small pot and bringing the milk to a boil over medium heat. Add the sugar and salt; stir until dissolved.

Dissolve the rice flour in the water, then pour it into the coconut milk while you stir with a rubber spatula. Keep stirring constantly until the coconut milk returns to a boil and the mixture has thickened. Remove the coconut cream from the heat, discard the pandan leaf, and let cool.

Sprinkle the tapioca pearls into the boiling water and stir until the water returns to a boil. Then stop stirring and let them boil for 12 to 13 minutes. Meanwhile, prepare a small bowl of cold water to check doneness.

Check the doneness of the pearls by putting a small amount into the cold water. The pearls are done when any white centers remaining in the pearls look no larger than a tiny dot.

Drain the pearls through a metal fine-mesh sieve and run cold water through them until completely cool. Shake off excess water and transfer to a mixing bowl. If you’re not ready to serve, you can leave them at room temperature, covered, for up to 4 hours. For the best texture, it’s better to not refrigerate them.

To assemble, stir the coconut cream (it can be warm, room temperature, or cold) and the young coconut meat into the pearls, mixing well. You can taste the pudding with a piece of mango and add more sugar and/or salt as needed, depending on the sweetness and tartness of the mangoes.

Spoon into a small serving bowl and top with a generous helping of mango pieces. Serve within 30 minutes of mixing. The tapioca pearls will continue to absorb moisture from the cream as they sit, so the longer they sit, the less soft and creamy the texture will be. If you have any leftovers, you can store them in the fridge, but the texture will not be as good the next day.

Notes

If not using pandan leaf, use palm sugar instead of granulated sugar for added flavor.

If the mango is very sweet, use less sugar, and vice versa. Also, if you’re serving right after assembly, use less sugar, as the sugar will not have had time to absorb into the pearls and the dish will taste sweeter than if it had.

Make sure you use the tiny tapioca pearls that are no larger than 1/16 inch (2 mm) in diameter; they’re available in white or a mix of pink, green, and white.

Do-ahead: You can make the coconut cream in advance and either keep it at room temperature for up to 8 hours or refrigerate it for up to 3 days.

Tapioca pearls can be cooked up to 4 hours in advance and left at room temperature.

Excerpted from Sabai by Pailin Chongchitnant. Copyright © 2023 Pailin Chongchitnant. Photographs by Janis Nicolay. Published by Appetite by Random House®, a division of Penguin Random House Canada Limited. Reproduced by arrangement with the Publisher. All rights reserved.

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My parents escaped South Africa during apartheid and came to Canada, so I grew up in Slave Lake, a rural community of about 6,000 people in northern Alberta. In a place that size, you learn to get along with everybody. After I finished high school, I went to the University of Alberta in Edmonton, then applied for medical school and was rejected many times. So I returned to Slave Lake. I worked in forestry and adult education. After university, I got married to my junior high school sweetheart, Bill. His family had a business in oil and gas. We took over the business and grew it to 15 employees, but it’s a tough industry to work in. There are many things to worry about—the cold, worker safety, addictions. We enjoyed the challenge but, at a certain point, we recognized it was no longer fulfilling for us. We decided to shut it down.

I’d been working for the town part-time as a coordinator. It was quite toxic—lots of bullying and unethical behaviour. It hit me that this was not the type of environment I wanted to work in. I decided to run for mayor. I wanted to reset the culture and build strength in our community. I was 33. Some people didn’t take me seriously because of my age. Other candidates said it was “nice to see young people getting involved.” But I put together a large team and we door-knocked relentlessly. I was strategic about getting the vote out. In the end, I had more votes than all the men combined.

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I was elected mayor first in 2004 and won two more elections after that. In 2011, midway through my third term, a major wildfire broke out on the outskirts of town. I met with my team in the town office, a building we’d built one year prior. Someone ran in and shouted, “The roof’s on fire!” Fierce 100 kilometre-per-hour winds were carrying balls of fire through the sky and into the town. Something inside me kicked in at that moment. I didn’t think about my own life or my safety, I only thought about what we needed to do for our community. As we were running out of the building, fire was falling from the sky. But my focus never changed. We had a sense of duty to our community. We worked through the night for days on end with very little sleep. You learn very quickly to check your ego at the door and look for the common goal.

At the time, the Slave Lake fire was the second largest weather disaster in Canadian history: One third of the town’s buildings burnt to the ground. The fire changed the lives of everyone who lived through it. It was hard and horrible, but we benefited from a remarkable wave of support from Alberta, across Canada and the globe. From the start, we were laser-focused on rebuilding. By March 2013, we’d rebuilt the town hall. We created a manuscript for other municipalities about our lessons learned from the disaster, which has, sadly, been used for guidance many times since then. In Western Canada, we experienced multiple significant disasters that eclipsed the Slave Lake fire—the 2013 flooding in southern Alberta, the 2016 fires in Fort McMurray and a series of wildfires and heatwaves across British Columbia.

Through all of this, medicine was still on my mind. During my last summer as mayor, as the new town hall was going up, I started studying for the medical school entrance exam again. It was an enormous challenge. I was using textbooks from 20 years ago. But the skills that I had developed as mayor—leadership, community building, resource management—helped me to get into medical school. I started at the University of Calgary in the summer of 2013.

My rule is that I don’t doubt myself until I give something a go. You don’t know until you try it. Life is about learning and trying, again and again. Be a lifetime learner.

Medical school was tough. I was 42 when I started. When I walked into my first class, I carried a pen and paper, and everyone else brought their laptop. (I bought a Mac later that week.) You don’t get breaks for being a mature student. You work the same hours as everyone.

I was drawn to family medicine, so I joined a practice in Calgary. I like challenges, and it’s a challenge. Family doctors help manage someone’s health, but we also help with social issues because we’re looking at the preventative side.

I’d just completed my second year of practice when the pandemic struck. It has not been an easy ride. It’s a joy and a privilege to be part of someone’s journey, but I would say that this is probably the toughest career I’ve been in. It can consume you, with its need for constant empathy and compassion. I worry so much about my patients—just like I worried about my community as mayor. But as a physician, you have to learn how to set boundaries from work. You could be there more than 10 hours a day, every day.

I’m planning to keep doing this for a while. That said, I do have my next career challenge in mind. I’ve applied to become a member of the Canadian Senate. Since 2016, Canadians can apply to the Independent Advisory Board for Senate Appointments. This body is designed to ensure that senators are non-partisan and reflect Canada’s diversity. I don’t know if I’ll be considered. But for me, one of the roles of a senator is to represent vulnerable populations. As a woman of colour, I would not take that responsibility lightly. It would even mean leaving medicine, because I couldn’t do both jobs. As a family doctor, you need to be there for your patients.

I feel like I’ve lived multiple lives with all my experiences. I got here by being a lifelong learner and keeping my mind open to experiencing new things.

When I graduated from medical school, I was asked to speak at our graduation. My message remains true: You may have graduated, but you are a learner still. Be kind to others who are learning—you will be learning from them, too.

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I’m always looking for a new way to add a little je ne sais quoi to my makeup look, which typically means updating my lipstick colour. For years I leaned on long-wear matte options (remember the Kylie Lip Kit craze?), but now I’m turned off of anything that leaves my lips feeling remotely chapped. I’ve tried lip glosses, lip stains and even hydrating lipsticks, but found them all to be too drying. Conveniently, there’s a new buzzy lip product on the scene that’s everything I’ve been looking for—lip oil.

What is lip oil?

Sitting somewhere between a lip balm and gloss, lip oils are the best of both worlds. They’re nourishing and hydrating like a balm, and provide a tinted sheen like a gloss (but without the sticky ickiness). Lip oils are sometimes marketed as a hydrating serum, formulated with moisturizing and plumping ingredients like vitamin E, peptides and hyaluronic acid, which makes them a bit like a skin-care product.

Lip oils have been around for a while, but they’ve recently gained popularity thanks to TikTok users gushing over picks from various brands. One particular product, the Dior lip oil, has gone viral with the #diorlipoil hashtag garnering nearly 700 million views—and now retailers have a hard time keeping it in stock.

If lip oils are considered a “hydrating serum,” does that mean they’re good for your lips?

According to Renita Ahluwalia, founder and lead dermatologist at the Canadian Dermatology Centre, lip oils can be really good for your lips—but it depends on the ingredients they contain. Oil is a sealant, which locks in moisture, says Ahluwalia, but “if a product contains oil without some other hydrating ingredients, you’re not going to get a long-lasting hydration benefit.”

Ahluwalia says some lip oils are formulated with oils that provide “superficial hydration” (like Dior’s version, which contains cherry oil), meaning they can make lips look hydrated, but won’t provide long-term benefits.

So, what ingredients in a lip oil should I look for if I want hydration?

“If you’re looking for a product that’s both an aesthetic product and provides long-term hydration, look for ingredients like hyaluronic acid which draws water into the skin,” says Ahluwalia.

Other ingredients to look for include peptides (which encourage the body to produce collagen), squalane (which offers more hydration) and shea butter (which softens skin), she says.

Is there anything I should be aware of?

Do a patch test before using it—as you should do with any new product. Ahluwalia says that some ingredients like coconut oil and jojoba oil can cause seborrheic dermatitis (which manifests in dry, flakey red patches) in those who are predisposed. Some people, especially those with sensitive skin, might also have reactions to scented oils in some products.

Which lip oil should I try?

Below, our favourite picks.

Best Hydrating Lip Oil: Kosas Wet Lip Oil Plumping Treatment Gloss

This lightly-tinted lip oil from clean beauty brand Kosas contains hyaluronic acid and peptides, which leaves lips feeling hydrated and looking plump.

$28, sephora.com

Best Budget-Friendly Lip Oil: NYX Fat Oil Lip Drip

This budget-friendly lip oil contains squalane and promises to provide 12-hour hydration. It’s currently trending online, which has led it to sell out in drugstores everywhere. But don’t worry—it’s available in some shades on the brand’s website.

$14, nyxcosmetics.ca

Best Splurge Lip Oil: Dior Lip Glow Oil Color

This lip oil is definitely worth the hype (and price tag): It’s non-sticky and non-greasy and provides a beautiful gloss in six subtle tints.

$50, shop.shoppersdrugmart.ca

Best Tinted Lip Oil: Rare Beauty Soft Pinch Tinted Lip Oil

This lip oil—from singer-actor Selena Gomez’s buzzy makeup line, Rare Beauty—delivers long-wearing colour and sheen. When first applied, the innovative formula looks and feels like a gel and then dries into an oil. The best part? It’s also a lip stain—it’ll leave a tint on lips that lasts hours after application.

$26, sephora.com

Best Untinted Lip Oil: Burt’s Bees Hydrating Lip Oil

Burt’s Bees’ lip oil is formulated with sweet almond oil, which contains fatty acids and antioxidants, which smooth and hydrate skin. It doesn’t have a tint, so you can layer it under your favourite lip shade if you want some colour.

$10, shop.shoppersdrugmart.ca

Best Drugstore Lip Oil: Quo Lip Oil

This lip oil from Quo is super affordable (just $10!), non-sticky (hair doesn’t get stuck to it!) and made without animal testing (cruelty-free!).

$10, shop.shoppersdrugmart.ca

Best Scented Lip Oil: Clarins Lip Comfort Hydrating Oil

Often cited as a dupe for the Dior lip oil, this one from Clarins uses a cocktail of oils (jojoba, hazelnut and sweetbriar rose) to hydrate, nourish and protect lips. It also provides a sheer hue and boasts a light, pleasant fragrance reminiscent of a Lip Smacker lip balm.

$32, sephora.com

Best “My Lips But Better” Lip Oil: Haus Labs PhD Hybrid Lip Oil

Lady Gaga’s Haus Labs’ lip oil is formulated with vegan collagen and plant squalane for a super-nourishing shine. It changes colour depending on the pH of your lips, so the tint is sure to complement your skin tone.

$31, sephora.com

Best Clean and Vegan Lip Oil: Merit shade Slick Gelee Sheer Tinted Lip Oil

Clean beauty brand Merit has a lip oil with a vegan formulation, leaning on plant squalene for hydration. It’s tinted and lightweight, making it perfect for no-makeup makeup looks.

$31, sephora.com

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Babies, young children and teens are the age groups most at risk of meningitis B, a disease that can be fatal in less than 48 hours. Kate Healy shares her harrowing experience and why parents should talk to their doctor about vaccination.

Invasive meningococcal disease (IMD) is a serious bacterial infection that can cause meningitis, which is inflammation of meninges, the protective lining of the brain and spinal cord. If the infection enters the bloodstream, it can lead to septicemia, a life-threatening blood poisoning.

Most IMD cases in Canada are caused by five main groups of the bacteria Neisseria meningitidis: groups A, B, C, W-135 and Y. Meningitis B is a form of IMD that’s caused by group B strains, which cause the majority of IMD cases in Canada. Since 2007, there have been an average of 111 cases of meningitis B per year in the country.

“The incidence of meningitis B is low, but mortality is quite high,” says Dr. Christine Palmay, a family physician at the Midtown Health and Wellness Clinic in Toronto. “When it happens, it’s a huge tragedy because it’s avoidable.”

The bacteria that cause meningitis B live in the nose and throat and can be spread easily through everyday behaviours like coughing, sneezing, living in close quarters, kissing and sharing food and drinks.“ Meningitis B is a disease of proximity,” she explains. “We believe it’s transmitted through close contact, saliva, even just sharing things like utensils.” Meningococcal meningitis can cause local epidemics in university or college dorms, boarding schools and military bases.

Meningitis can impact all ages, but infants and children under five are most at risk of developing the disease, followed by adolescents aged 15-19.

Kate Healy was only 16 when she woke up one morning with cramped muscles, a fever and purplish spots on her knees. She’d just finished working as a counsellor at a summer camp. “I was feeling fluish. It’s normal if you’ve ever been to or worked at camp. Usually you get sick at some point.” By late afternoon, she’d grown extremely weak and the rash on her legs was spreading. Her parents rushed her to the hospital but her condition deteriorated rapidly. She was later airlifted to a bigger hospital and put into a coma.

Within 24 hours, Kate went from being kind of sick to critical. “They said I may not survive through the night,” she says. “My mom describes it as one of the scariest moments of her life. What do you do when you have a child who was fine and then all of a sudden isn’t?”

Doctors feared Kate would become paralyzed or suffer brain damage, but miraculously, she improved. After a week in a coma and a month in hospital, she went home. “It was really the beginning of the story, because I still had a lot of work to do,” she says. “I had physio, wound-care clinic and specialist appointments. It just began a months-long recovery.”

Because of septicemia, she lost part of a toe and had wounds on her legs that had to be cleaned, scraped and bandaged every day for two months. The scarring on her legs required corrective surgery.

Kate also lost time she can never get back. “I missed months of school. I wasn’t with friends. I was in eleventh grade, a big formative year for me. I felt isolated and lonely.” Her entire family was impacted physically, emotionally and financially. “My parents had to take time off work. My younger sister had a lot of fear and anxiety. It was a life-defining experience for all of us in different ways.”

She was incredibly fortunate not to have any serious lasting effects and knows that’s not the case for many who have contracted the disease. Up to 1 in 10 IMD patients die, often within 24–48 hours of symptom onset.

“Death is so tragic,” says Dr. Palmay. “But we often forget about morbidity, whether that’s psychological changes, losing limbs because gangrene sets in, paralysis. What about the consequences in patients who are suffering long-haul?” As many as 20% of IMD survivors experience lifelong complications such as hearing loss, mental disabilities and limb amputation.

It’s important for parents to recognize the signs and get medical attention immediately.

Early symptoms of meningitis can be hard to notice because they begin mildly and can be similar to those of a cold or flu. “The morbidity and mortality related to meningitis B cases is high,” Dr. Palmay says, “partially because symptoms are non-specific initially — general flu-like symptoms, cough, mild fever, just not feeling well.” Other early symptoms include headache, fatigue, irritability, loss of appetite, nausea, vomiting and muscle aches.

“This isn’t a disease that’s easily identifiable and it’s got huge ramifications,” she says. “By the time you’ve identified that this isn’t a general virus, you’re already at the 12-hour mark.” That’s when worrisome symptoms like neck stiffness and rashes appear. “It evolves so quickly and patients deteriorate fast. At 24 hours, in some cases where patients have been missed, they end up dying, in part because you miss so much time thinking it’s a non-serious issue.”

Your best shot at prevention is to have your child vaccinated.

Dr. Palmay recommends vaccination against meningitis B based on risk — infants are vulnerable because of their weakened immune systems, while older teenagers aged 16+ are susceptible due to contact. She suggests that parents have a discussion with their doctors about meningitis vaccines because they can be confusing.

There’s no single vaccine that protects against all vaccine-preventable strains of meningococcal bacteria.“ People assume it’s one shot, but there are multiple serotypes or groups. I spend time differentiating them with my patients and explaining why meningitis B is different.”

Most infants in Canada receive a meningococcal vaccine that covers group C strains. Teens typically receive a vaccine that protects against 4 meningococcal groups: A, C, Y and W-135. None of these vaccines protect against group B strains. Meningitis B vaccines have only been available in Canada since 2014 and aren’t currently included as part of the routine childhood vaccination schedule in most provinces. So even if your child received a meningitis vaccine, they may be missing coverage for meningitis B.

“It takes time for vaccines to be adopted,” says Dr. Palmay. “My hope would be that Canada would follow suit with countries like the UK, Portugal and Italy, which have infant immunization programs for meningitis B.”

She encourages parents to keep track of their family’s vaccinations by creating a digital record using the CANImmunize app. There are timing issues for multi-dose series vaccines like meningitis B and COVID-19, and it’s important to know what you received and when.

Unfortunately, there were no vaccines available in Canada for meningitis B when Kate contracted it. Thankfully that has now changed. Her advice is to talk to your doctor about what meningitis vaccines are available even if you think your kids are fully vaccinated. “The more proactive measures people take such as getting vaccinated, the less likely it is for anyone to experience what I went through.”

Speak to your doctor to help ensure your child is protected against all strains of vaccine-preventable meningococcal disease, including meningitis B.

Learn more at missingb.ca.