What health literacy means

Health literacy is your ability to find health information, understand it, and use it to make decisions about your health. All three parts matter: finding a page about a rash doesn't help if you can't tell whether it applies to you.

You already make health decisions every day: what you eat, how much you sleep, whether to try a product you saw online. Health literacy is a set of habits, not a pile of medical facts: asking good questions, checking where claims come from, and knowing who to turn to.

Where you get health information

Every source has strengths and weak spots:

• Social media is fast and relatable, but anyone can post, attention-grabbing videos spread fastest, and many creators are paid to promote products.
• Friends and family care about you, but what worked for one person may not work for you.
• Search engines are quick, but top results aren't always the most accurate, and some are ads.
• AI chatbots can explain terms in plain language, but they can sound confident while being wrong, may not show their sources, and don't know your health history.
• School (health class, the school nurse, a counselor) offers information aimed at your age group and can point you to more help.
• Doctors, nurses and pharmacists are trained and can look at your actual situation. The trade-off is that it takes more effort than a quick search.

How to judge a source: five questions

Before you trust a health claim, run it through this checklist:

• Who is behind it? Is a real person or organization named, with expertise in this health topic?
• Is it selling something? Look for discount codes, "link in bio" or sponsored posts. Selling isn't automatically dishonest, but it's a reason to be careful.
• How current is it? Look for a date. Health advice changes as scientists learn more.
• Does it show its evidence? "Studies show" with no details isn't evidence.
• Do other reliable sources agree? If only one site or creator makes a claim, be skeptical.

Web addresses give clues. In the US, .gov sites belong to government agencies and .edu sites to colleges and universities (though a .edu page might be one student's class project). Anyone can run a .org or .com site.

Good starting points include MedlinePlus.gov for plain-language health topics, CDC.gov for prevention and healthy habits, and FDA.gov for medicine, food and product safety. They're starting points, not the last word: they give general guidance for most people and update it as evidence changes. A doctor, nurse or pharmacist can tell you how it applies to you.

Red flags, and why one study isn't the final answer

Misinformation often follows a pattern. Be extra careful when you see:

• Miracle cures: one product that fixes many problems fast, or is "totally natural and safe."
• "Doctors don't want you to know": claims that experts are hiding a secret. Real medical advances are usually published and discussed openly, not kept secret.
• One personal story as proof: a testimonial or before-and-after photo instead of evidence.
• Pressure to buy now: countdown timers, "limited stock" or codes that expire tonight.
• Advice to skip real care: quitting a medicine or avoiding your doctor. Never stop or change a medicine without talking to your doctor or pharmacist first.

Sometimes a post points to real research: "A new study proves it!" That's better than nothing, but a single study is rarely settled science. It might have been small, done only in animals or a lab, or found that two things happened together without showing that one caused the other. Headlines often make results sound bigger than they are.

Scientists become confident when many studies by different teams point the same way. That shared conclusion, called scientific consensus, is what official guidance is built on. Treat "one study says" as interesting news, not a reason to change what you do.

Protect your privacy, and know when to ask a person

What you search for and post about your health can be tracked, used for ads, or seen by more people than you expect. The federal health privacy law, HIPAA, covers information held by your doctors, clinics and health insurance, but generally not search engines, social media or most apps. Don't post your symptoms or a friend's publicly, and keep your name and other identifying details out of symptom checkers, quizzes and chatbots.

Rules about what stays private between a teen and a doctor vary by state. If you're unsure, ask your doctor or the school nurse how it works where you live.

Searching has limits. Stop searching and talk to a doctor, nurse, pharmacist or trusted adult when a symptom is severe, getting worse or not going away; before starting or stopping a medicine or supplement; when sources disagree; or when searching makes you more worried, not less. A professional can examine you, which no website can do.

In an emergency, call 911. If you or a friend is struggling emotionally or thinking about suicide, call or text 988, the Suicide & Crisis Lifeline, any time, day or night.

Your options for care

Each place to get care is built for a different kind of need:

• Primary care provider (PCP): your regular doctor, nurse practitioner or physician assistant. They handle checkups, ongoing care, everyday illnesses, and referrals to specialists when you need one. They know your history, so they're usually the best first call for anything that isn't urgent.
• Urgent care: walk-in clinics, often open evenings and weekends, for problems that aren't life-threatening but can't wait for a regular appointment.
• Emergency room (ER): open around the clock for serious, life-threatening emergencies. If someone might be in danger, call 911 instead of driving them yourself.
• Telehealth: a visit by video or phone. It can work well for many questions and follow-ups, but not for emergencies or anything that needs a hands-on exam.
• School nurse or school-based health center: help during the school day, from first aid to support for ongoing conditions. Some schools have a clinic with more services.
• Pharmacist: an expert on medicines. Ask a pharmacist how to take a medicine, what side effects to watch for, or whether two products are safe together, usually without an appointment.

A regular checkup (sometimes called a well visit) matters even when you feel fine. It's a chance to stay up to date on vaccines, catch problems early, and get to know a provider before you need them.

Where should I go?

Here are some general examples. This is not medical advice, and every situation is different. If you're not sure whether something is an emergency, call 911. It's always better to call and not need it.

Two other numbers are worth knowing. If someone may have swallowed or touched something poisonous, call the Poison Help line at 1-800-222-1222 (call 911 if they're not breathing or won't wake up). If you or a friend is thinking about self-harm or is in crisis, call or text 988, any time, and tell a trusted adult.

Getting ready for an appointment

Visits can be short, and it's easy to forget things once you're in the room. Beforehand, write down:

• Your symptoms: what they are, when they started, and what makes them better or worse.
• Medicines you take: prescriptions, over-the-counter medicines, vitamins and supplements. Bringing the bottles or a photo of the labels works too.
• Allergies: to medicines, foods or anything else, and what happened.
• Your questions: put the most important one first, in case time runs short.

During and after the visit

Be honest, even about things that feel awkward. Your provider can only help with what they know, and if you don't know an answer, it's fine to say so.

Ask questions until the plan makes sense. Three good ones to remember:

• What is my main problem?
• What do I need to do?
• Why is it important for me to do this?

Then use teach-back: repeat the plan in your own words, like Ethan did. It's not a test of you; it's a check that the explanation was clear.

After the visit, follow the instructions you were given, and call the office if you're confused or things aren't improving as expected. Many offices have a patient portal, a secure website where you can see visit notes and test results or send a message to your care team. What teens can see on a portal depends on the office and the state.

Know your health information

Soon you'll be the one filling out the forms. Start learning these now, with help from a parent or guardian:

• Allergies, and what reaction you had.
• Medicines you take regularly.
• Family history: health conditions that run in your family, such as diabetes or heart disease.
• Vaccination record: where to get a copy. Your doctor's office can usually help.
• Your primary care provider's name and phone number.

Privacy and consent: your health information is private, but the rules for teens are not the same everywhere. What care you can agree to on your own, and what a parent or guardian can see, vary by state and by type of care. If you're unsure, ask the clinic about its confidentiality policy, or ask your school nurse.

Insurance: health insurance helps pay for care, and offices usually ask for your insurance card. Terms like premium, deductible and copay are covered in the ABLE Business Financial Literacy course. For now, know whether you have coverage and where the card is.

Two kinds of medicine

Over-the-counter (OTC) medicines, like many pain relievers and cold medicines, can be bought without a prescription. The FDA allows this because they're considered safe to use on your own when you follow the label.

Prescription medicines need an order from a licensed prescriber, such as a doctor, nurse practitioner or dentist. A pharmacist fills that order for one specific person, based on that person's age, health, allergies and other medicines.

"Over-the-counter" doesn't mean "harmless." Taking too much, too often, or mixing the wrong ones can cause serious harm. As a teen, check with a parent, guardian or school nurse before taking any medicine.

Reading the Drug Facts label

Every OTC medicine in the US has a Drug Facts label with the same sections in the same order:

• Active ingredient: the medicine that does the work, how much is in each tablet or spoonful, and its purpose (for example, "pain reliever/fever reducer").
• Uses: the symptoms or conditions the product is meant to treat.
• Warnings: who shouldn't use it, what to ask a doctor or pharmacist about first, side effects (like drowsiness), when to stop, and what to do if someone takes too much.
• Directions: how much to take, how often, and the most in a day, usually by age. Follow them exactly, and measure liquids with the cup or syringe that comes with them, not a kitchen spoon.
• Other information: mainly how to store the product.
• Inactive ingredients: colors, flavors, fillers and so on. They matter if you have an allergy.

The big one: two different products can contain the same active ingredient. A multi-symptom cold medicine and headache pills may both contain a common pain reliever and fever reducer, so taking both could mean far more of it than is safe. Before taking two medicines, compare their "Active ingredient" sections.

Prescriptions: only for the person they're for

Never share your prescription medicine, and never take someone else's, even for the same symptoms. It was chosen for that person's body and health history; what's safe for them could be dangerous for you.

A prescription label usually shows the patient's name, the medicine and its strength, the directions, the prescriber, the pharmacy's phone number, the fill date, refills left, and a date after which not to use it. Pharmacies often add warning stickers, like "may cause drowsiness." If anything isn't clear, ask the pharmacist.

Antibiotics deserve special attention. They fight bacteria, but they don't work on viruses, like the ones that cause colds and flu. An antibiotic you don't need won't help, can cause side effects, and helps bacteria become resistant. When you are prescribed one, take it exactly as prescribed: don't skip doses, don't stop early without asking your doctor, and don't save or share leftovers.

Mixing: other medicines, supplements and alcohol

An interaction is when something changes how a medicine works: weaker, stronger, or with new side effects. Medicines can interact with other medicines, supplements, alcohol and sometimes foods.

Dietary supplements (vitamins, herbal products and similar) aren't reviewed by the FDA for safety and effectiveness before they're sold, the way medicines are. "Natural" doesn't mean "safe."

To check, ask a pharmacist; you can usually ask at the counter without an appointment. Tell them everything you take, including OTC medicines and supplements. MedlinePlus.gov also explains medicines in plain language.

Storing, disposing and getting help

Storing: keep medicines in their original containers, store them as the label says, and keep them up, away and out of sight of young children, as every Drug Facts label reminds you.

Disposing: leftover medicines can be taken by mistake or misused. Many communities have drug take-back sites, such as drop-off boxes at some pharmacies or police stations. If there isn't one near you, follow the FDA's disposal guidance on FDA.gov. Don't flush medicines unless the label or FDA guidance says to.

Getting help: if someone took too much, the wrong medicine or someone else's, or a child got into medicine, call Poison Help at 1-800-222-1222 right away, even if they seem fine. Experts answer, free and confidential, around the clock. Don't make someone throw up unless an expert tells you to.

Call 911 if the person collapses, has a seizure, has trouble breathing, or can't be woken up.

Start at the top: serving size

Almost every packaged food and drink in the US has a Nutrition Facts label. The two lines at the top matter most, because everything below them depends on them.

• Serving size is the amount all the numbers on the label describe, such as 1 cup, 12 fluid ounces or 15 chips. It's based on how much people typically eat or drink at one time. It is not a recommendation for how much you should have.
• Servings per container tells you how many of those servings are in the whole package.

Every number below those lines, including calories, sugars and sodium, is per serving. If a package holds more than one serving and you eat or drink all of it, multiply each number by the servings you actually had.

Calories measure the energy a food gives your body. Everyone needs energy, and how much depends on your age, body, growth and how active you are, so there is no single "right" number for everyone. The label's calorie number is useful for comparing foods, not for judging them.

Try the calculator below with any label you have nearby.

% Daily Value and the 5%/20% guide

The % Daily Value (%DV) column shows how much one serving adds toward a general daily reference amount for each nutrient. The label bases it on 2,000 calories a day as a general reference; your own needs may be higher or lower, but %DV still works well for comparing products.

The FDA gives a quick guide:

• 5% DV or less of a nutrient per serving is low.
• 20% DV or more of a nutrient per serving is high.

The label itself points you toward nutrients to watch. Most people benefit from getting less of added sugars, sodium and saturated fat, and more of dietary fiber, vitamin D, calcium, iron and potassium. So a low %DV is usually what you're looking for with sodium, and a high %DV is a plus for fiber or calcium.

The ingredients list and the front of the package

The ingredients list is usually printed near the Nutrition Facts label. Ingredients are listed in order by weight, from most to least. If sugar or a syrup is one of the first few ingredients, there's a lot of it. If fruit shows up near the end, there's only a little.

The front of the package is designed to sell. Words like "natural," "made with real fruit," or "wholesome" can be true and still not tell you much. "Made with real fruit" doesn't say how much fruit, and "natural" doesn't tell you anything about the added sugars, sodium or saturated fat inside. When a claim catches your eye, turn the package over and check it against the label and the ingredients list.

Drinks count too

Drinks are easy to overlook because they don't feel like food. But sodas, sweet teas, energy drinks, sports drinks and many coffee and juice drinks can carry a lot of added sugar, and bottles often hold more than one serving, as Diego found out.

Water is a great default drink: it has no calories or added sugars, and your body needs it every day. You need more when it's hot or when you're active. Carrying a refillable water bottle makes it easy. Plain milk or a fortified soy alternative can also be part of a balanced day.

This doesn't mean you can never have a sweet drink. It means knowing what's in it so you can choose.

Building a balanced plate

Labels help with packaged foods, but a lot of healthy eating is simpler than reading numbers. USDA's MyPlate uses a picture of a plate to show a balanced meal:

• Vegetables and fruits fill about half the plate. Fresh, frozen and canned all count.
• Grains such as rice, bread, pasta, tortillas or oats. Choose whole grains often: aim for at least half your grains to be whole grains.
• Protein such as beans, eggs, fish, chicken, tofu, nuts or meat. Variety helps.
• Dairy or alternatives such as milk, yogurt, cheese, or fortified soy milk.

Not every meal has to look like the picture. It's a pattern to aim for across your day and week, and it works with the foods your family and culture already eat.

No single food is good or bad. Foods can fit into a balanced pattern in different amounts, and eating should also be enjoyable and social. Bodies come in many healthy shapes and sizes. This lesson isn't about dieting or cutting calories. If you want advice for your own body, health or sport, talk to a doctor or a registered dietitian. If eating ever feels out of control, stressful or scary, please talk to a parent, school nurse, counselor or another trusted adult. You don't have to figure it out alone.

How much sleep you need, and why it matters

Teens aged 13 to 18 are recommended to get 8 to 10 hours of sleep every 24 hours. That guidance comes from the American Academy of Sleep Medicine and is also used by the CDC.

Too little sleep shows up in ways you can feel:

• Mood. You're more likely to feel irritable, low or anxious.
• Focus and memory. It's harder to pay attention and remember what you studied.
• Safety. Sleepiness slows your reactions. Drowsy driving is dangerous: a tired driver can react too late or nod off without realizing it. If you're too sleepy to drive, don't.

Your body clock and better sleep habits

Your body runs on an internal clock, your circadian rhythm, that tells you when to feel sleepy and alert. During the teen years, that clock naturally shifts later: your brain releases melatonin, a hormone that signals "time to sleep", later in the evening than when you were younger. So you may not feel tired until late, even with an early alarm. It's biology, not laziness.

You can't change your body clock completely, but these habits help:

• Keep a consistent schedule. Go to bed and wake up at about the same times every day, weekends included.
• Dim the lights and screens before bed. Bright light from phones and laptops tells your brain it's still daytime, and scrolling keeps your mind busy. Put screens away for a while before bed.
• Watch caffeine later in the day. Caffeine in coffee, some teas, many sodas and energy drinks can stay in your body for hours, so having it in the afternoon or evening can make it harder to fall asleep.

If you still have trouble sleeping most nights, talk to a parent or guardian and your doctor rather than trying sleep medicines or supplements on your own.

To plan a bedtime, count backwards from when you need to wake up. Try the calculator below.

Stress: what it is and how to cope

Stress is your body and mind reacting to a challenge, like a test, a tryout, a fight with a friend, or too much to do at once. Your heart may beat faster and your thoughts may race.

Some stress is normal and even useful: it can help you focus before a big game. It becomes a problem when it's overwhelming: it doesn't let up, or it keeps you from sleeping, eating or getting through the day.

Healthy coping skills help you handle stress without making things worse:

• Sleep. Everything feels harder when you're tired.
• Move your body. A walk, dancing or a sport can take the edge off.
• Slow your breathing. Breathe in slowly, then breathe out even more slowly, a few times.
• Break big tasks down. "Study for finals" is overwhelming; "review one chapter tonight" is doable.
• Talk to someone. A friend, family member or counselor can help you see a problem differently.
• Get outside. Time outdoors helps many people feel calmer.

Some ways of coping feel like they help in the moment but make things worse, such as alcohol or drugs, staying up all night, or pulling away from everyone. If that's what you're reaching for, talk to a trusted adult.

Mental health is part of health

Your mental health is how you think, feel and cope with life. Like physical health, everyone has it, it changes over time, and it sometimes needs care. Struggling is common, it isn't a weakness, and help works.

Everyone has hard days. Someone may be struggling when changes like these last for weeks or get in the way of daily life:

• Sleeping or eating a lot more or a lot less than usual.
• Pulling away from friends, family or activities they used to enjoy.
• Seeming sad, empty, worried or irritable most of the time.
• Talking about feeling hopeless, being a burden, or not wanting to be alive. This one always needs a trusted adult's help right away.

You don't need to figure out what's wrong. These signs just mean it's time to check in and get a trusted adult involved.

Helping a friend, and getting help

If you're worried about a friend, you don't have to be an expert:

• Reach out and listen. Tell them what you've noticed and that you care. Let them talk without judging.
• Take it seriously. If they say they're thinking about suicide or hurting themselves, believe them. It's okay to ask them directly; asking doesn't put the idea in their head.
• Don't keep it a secret if they might be in danger. Even if they ask you to promise, their safety matters more.
• Involve a trusted adult. A parent or guardian, school counselor, teacher or school nurse can help. You don't have to carry this alone.

For yourself or a friend, good places to start are a parent or guardian, your school counselor or your doctor. What they keep private depends on the situation and your state's rules, but if someone's safety is at risk, they will act to keep that person safe.

You can always reach the 988 Suicide & Crisis Lifeline: call or text 988, any time, 24 hours a day, 7 days a week. It's free and confidential, and you don't have to be thinking about suicide to reach out: you can contact 988 if you're struggling, overwhelmed, or worried about someone else, and a trained counselor will listen and help. Learn more at 988lifeline.org.

If someone is in immediate danger, call 911.

Is it an emergency?

Most health problems can wait for a doctor's appointment or urgent care, as you saw in Lesson 2. An emergency could threaten someone's life, or cause lasting harm, within minutes. Call 911 right away if someone:

• Isn't responding: you tap them and shout, and they don't react.
• Isn't breathing normally: not breathing at all, or only gasping. Gasping is not normal breathing.
• Is bleeding heavily. Apply firm pressure with a clean cloth and keep pressing while someone calls.
• Has chest pain or pressure.
• Shows signs of a stroke. Think F.A.S.T.: Face drooping on one side, Arm weakness (one arm drifts down when they raise both), Speech difficulty (slurred or strange words), Time to call 911. Note when the signs started.
• Is having a severe allergic reaction with trouble breathing.
• Is having a seizure: sudden, uncontrolled shaking or stiffening.
• May have been poisoned or overdosed and is collapsed, very drowsy or hard to wake.

If you aren't sure it's serious enough, call anyway. Dispatchers would much rather hear about something minor than miss something serious.

How to call 911 well

The person who answers is a trained dispatcher who sends help and can talk you through what to do. A good call follows a simple order:

1. Location first. The address, building and room, or the nearest cross streets or landmarks. If the call drops, they still know where to go.
2. What happened. "My friend collapsed and isn't breathing normally" beats a long story.
3. Stay on the line. Put your phone on speaker so your hands are free.
4. Follow the dispatcher's instructions. They may tell you exactly how to help, step by step.
5. Don't hang up first. Wait until the dispatcher tells you it's OK.

In some areas you can text 911 if it isn't safe to speak, but call when you can.

Safety first, then hands-only CPR

Before you go to someone, check that the scene is safe for you: traffic, fire, fumes, fallen power lines, a fight. If it isn't safe, stay back and call 911. You can't help if you get hurt too.

If a teen or adult suddenly collapses and isn't responding or breathing normally, their heart may have stopped. Here's what hands-only CPR looks like:

1. Call 911, or point at one specific person and tell them to call. Send someone to get an AED if there is one.
2. Push hard and fast in the center of the chest, about 100 to 120 pushes a minute. Let the chest come back up between pushes.
3. Don't stop until trained help takes over, an AED is ready to use, or the person starts to wake up or breathe normally. Take turns with someone else if you tire.

An AED (automated external defibrillator) is a portable device often kept in schools, gyms and airports. Once you turn it on, it talks you through every step: where to put the pads, when to stand clear, when to keep pushing.

This lesson explains the idea, but it can't train your hands. A certified CPR course, such as one from the American Heart Association or the American Red Cross, is the right way to learn. Courses also cover babies and young children, where CPR is different.

Poisoning, overdose and Good Samaritan laws

Poisoning can come from cleaning products, medicines, plants, chemicals or fumes. If someone may have swallowed, breathed in or touched something harmful and is awake and breathing normally, call the Poison Help line at 1-800-222-1222. Poison experts answer 24 hours a day. Keep the container handy so you can say exactly what it was.

Call 911 instead if the person has collapsed, is having a seizure, is having trouble breathing, or can't be woken up. The same goes for any possible overdose.

Some people hesitate because they're afraid of getting in trouble. Every state has some form of Good Samaritan law giving legal protection to people who help in an emergency. The details vary by state, but the message is the same everywhere: calling for help is the right thing to do.

After an emergency, and looking back on the course

Seeing someone get seriously hurt or sick is frightening, even when you did everything right. Afterward, it's normal to feel shaken, replay what happened or have trouble sleeping. Talk to someone: a parent or guardian, a coach, a school counselor or another trusted adult. If the feelings don't ease, or you're struggling, you can call or text 988, any time, as you learned in Lesson 5.

This is the last lesson, so look how far you've come. You can now judge whether health information is trustworthy, find your way around health care, use medicines safely, read a food label, protect your sleep and mental health, and act in an emergency. None of it requires being an expert, just asking good questions, reading carefully and speaking up, for yourself and the people around you. You're ready.

What nutrients are

Food is more than something that fills you up. It's made of nutrients: substances your body uses for energy, to grow, and to repair itself. As a teen, your body is still growing, so it's doing a lot with what you give it.

Nutrients come in two broad groups. Macronutrients are the ones you need in larger amounts: carbohydrates, protein and fats. They all provide energy. Micronutrients are vitamins and minerals, which you need in much smaller amounts but which are just as important. Fiber and water don't fit neatly into either group, but your body depends on both.

No single food has everything. That's why eating a variety of foods across the day and week matters more than any one meal.

The big three: carbohydrates, protein and fats

• Carbohydrates are your body's main source of energy. Your brain and your muscles both rely on them, which is why you can feel foggy or sluggish when you've gone a long time without eating. You'll find them in grains like rice, bread, pasta, tortillas and oats, and in fruits, vegetables, beans and milk.
• Protein is your body's building material. It helps build and repair muscles, skin, hair and many other tissues, and it's used to make things your body runs on, like enzymes. Beans, lentils, eggs, fish, chicken, meat, tofu, nuts, milk and yogurt all provide it. A variety of these across the day covers most people's needs.
• Fats give you energy too, help your body absorb vitamins A, D, E and K, and help build your cells, including in your brain. Nuts, seeds, avocado, olive oil and fish all have fats that are a helpful part of a balanced diet.

You need all three. Cutting one out completely leaves a gap that the others can't fill.

Fiber, vitamins, minerals and water

Fiber is a part of plant foods that your body doesn't fully digest. That's its job: it helps keep your digestion regular and helps you feel full. Vegetables, fruits, beans and whole grains are good sources.

Vitamins and minerals each have specific jobs. A few examples:

• Calcium and vitamin D help build strong bones, and your teen years are a key time for building bone.
• Iron helps your blood carry oxygen to your muscles and brain.
• Vitamin C helps your body heal cuts and scrapes and supports your immune system.

Colorful fruits and vegetables, dairy or fortified alternatives, beans, whole grains and protein foods together supply most of what you need.

Water is in every cell. It helps control your body temperature, carries nutrients around your body, and cushions your joints. Lesson 3 is all about staying hydrated.

Whole and highly processed foods

Whole foods are close to how they're found in nature: an apple, a bag of rice, eggs, dry beans. Many foods are processed in simple ways that keep them useful: frozen vegetables, canned beans, plain yogurt and whole-grain bread are all processed, and they're all great options.

Highly processed foods have been changed a lot from their original form and usually have many added ingredients. Think chips, candy, many packaged snack cakes and sweetened cereals. They're often higher in added sugars, sodium or saturated fat and lower in fiber than whole foods.

That doesn't make them "bad" or make you "bad" for eating them. They're convenient, they taste good, and they're part of social life. A useful goal is for most of what you eat to be whole or lightly processed, with room for everything else. To compare packaged foods, use the skills from the Health Literacy lesson "Food labels and everyday nutrition".

MyPlate's five food groups

MyPlate is a simple guide from the US Department of Agriculture (you can explore it at MyPlate.gov). It sorts foods into five food groups, and each group brings something different, building on the nutrients from Lesson 1:

• Fruits: fresh, frozen, canned or dried. Whole fruit gives you fiber that juice mostly doesn't.
• Vegetables: leafy greens, carrots, peppers, corn, tomatoes, and beans and lentils, which count as vegetables or protein foods.
• Grains: rice, bread, tortillas, pasta, oats, cereal. Make at least half your grains whole grains, like oatmeal, brown rice or whole-wheat bread.
• Protein foods: beans, lentils, eggs, fish, chicken, meat, tofu, nuts and seeds. Mixing them up over the week gives you a wider range of nutrients.
• Dairy: milk, yogurt and cheese, or fortified soy milk or soy yogurt if you don't drink milk.

Half your plate: fruits and vegetables

MyPlate's picture is easy to remember: make half your plate fruits and vegetables. The other half is split between grains and protein foods, with dairy on the side.

That works with almost any kind of food. A stir-fry with lots of vegetables over rice, tacos with beans and salsa plus a side of fruit, pasta with spinach and chicken, or a family recipe from your culture can all fit. Mixed dishes count; you don't need separate piles on your plate.

Not every meal has to match the picture. It's a pattern to aim for across the day. If lunch had no vegetables, add some at dinner or grab a fruit as a snack.

Breakfast and snacks

After a night without food, breakfast refuels you for the morning. It doesn't have to be cooked or fancy. Try to include two or three food groups:

• Oatmeal with fruit and milk
• Whole-grain toast with peanut butter and a banana
• Yogurt with cereal and berries
• Last night's leftovers, which are a perfectly good breakfast

If you're not hungry early, pack something to eat between classes.

Snacks are useful, especially on long days or before practice. A balanced snack pairs two food groups, which tends to keep you going longer than one alone: an apple and cheese, whole-grain crackers and hummus, carrots and a hard-boiled egg, or yogurt and fruit.

Eating well on a budget

Healthy eating doesn't have to cost more. A few strategies help:

• Frozen and canned fruits and vegetables are nutritious, last longer and are often cheaper than fresh. Look for canned fruit packed in water or juice.
• Beans, lentils, eggs and oats are some of the lowest-cost protein foods and grains.
• Buy produce that's in season, compare store brands with name brands, and shop with a list.
• Cooking at home and using leftovers usually costs less than eating out.
• Ask at school about free or reduced-price school meal programs. Many schools also serve breakfast.

Eating well on a busy schedule

Busy days are when planning pays off most. Meal prep can be as simple as washing fruit, cooking a pot of rice or beans on the weekend, or packing tomorrow's lunch after dinner. Keep a few non-perishable snacks in your backpack or locker, like nuts, whole-grain crackers or dried fruit. And when you do eat out, you can still use the plate idea: look for options with vegetables and fruit, and choose water or milk to drink.

Why water matters

As you saw in Lesson 1, water is in every cell of your body. It has several big jobs:

• Cooling you down. When you get hot, you sweat, and as sweat dries it carries heat away from your skin. That only works if you replace the water you lose.
• Moving things around. Water helps carry nutrients to your cells and waste out of your body.
• Protecting you. It cushions your joints and helps protect your brain and spinal cord.

You lose water all day through sweat, breathing and going to the bathroom, so you need to keep replacing it. Water from drinks counts, and so does water in foods like fruits, vegetables, soups and milk.

When you don't get enough, you can become dehydrated. Even mild dehydration can leave you tired, headachy, cranky or unable to focus, and it can make exercise feel harder than it should.

Two simple signs: thirst and urine color

How much water each person needs depends on their body, how active they are and the weather, so there isn't one amount that's right for everyone. Instead, pay attention to two simple signs:

• Thirst. Feeling thirsty is your body asking for water. Don't ignore it, and don't wait until you're very thirsty, especially when you're active.
• Urine color. Pale yellow usually means you're well hydrated. Darker yellow is a sign to drink more.

The easiest habit is to keep a refillable water bottle with you and sip through the day, including at meals.

Heat and exercise

You sweat more when it's hot and when you're active, so you need to drink more. When you're exercising, especially outside:

• Drink water before you start, so you don't begin behind.
• Take water breaks during activity, even if you don't feel very thirsty yet.
• Drink again after to replace what you lost.

Your coach or athletic trainer can help you plan for your sport. Feeling dizzy, very weak or sick in the heat can be a sign of heat illness: stop, get to shade and tell an adult right away. Heat stroke is an emergency: if someone is confused, passes out or seems very ill in the heat, call 911 and help cool them down while you wait. Lesson 5 covers heat illness in more detail.

Sugary drinks, caffeine and energy drinks

Sugar-sweetened drinks, like soda, sweet tea, fruit drinks and many coffee drinks, can have a lot of added sugar and little else your body needs. You don't have to avoid them completely, but make them an occasional choice rather than your everyday drink. Plain water, milk or fortified soy milk make better everyday choices; for a change, add slices of fruit or cucumber to water. To compare drinks, use the skills from the Health Literacy lesson "Food labels and everyday nutrition".

Caffeine is a stimulant found in coffee, many teas, many sodas and energy drinks. Too much can make you jittery, give you a racing heart or an upset stomach, and make it hard to sleep.

Energy drinks often combine a lot of caffeine with sugar or other stimulants. Pediatric experts advise teens to avoid energy drinks. If you ever feel your heart racing, chest pain or dizziness after caffeine, stop and tell a parent, school nurse or doctor.

Sports drinks: when they fit

Sports drinks contain water, sugar and electrolytes, minerals like sodium and potassium that you lose in sweat. They're mostly meant for long, intense exercise, especially in the heat, like Leila's tournament. For everyday activity, school and meals, water is all you need, and extra sports drinks just add sugar. If you're not sure what's right for your sport, ask your coach or athletic trainer.

Why moving matters

The food and drinks from the first three lessons are fuel. Physical activity is what puts that fuel to work. Regular activity makes your heart and lungs stronger, builds muscle, and helps your bones grow strong, and your teen years are an important time for building bone.

The benefits aren't only physical. Being active can lift your mood, help you handle stress, help you focus in class, and help you sleep better at night. (Health Literacy's lesson on sleep, stress and mental health covers those in more detail.)

None of this requires being "sporty". Walking, dancing in your room, shooting hoops alone or skateboarding with friends all count. The best activity is one you'll actually keep doing.

The guideline: 60 minutes, every day

The Physical Activity Guidelines for Americans, published by the US Department of Health and Human Services at Health.gov, say that children and teens aged 6 to 17 should get 60 minutes or more of moderate-to-vigorous physical activity every day.

As part of those 60 minutes, the guidelines also ask for three kinds of activity, each on at least 3 days a week:

• Vigorous activity, the kind that makes you breathe hard, like running or a fast game of soccer.
• Muscle-strengthening activity, where your muscles work against resistance: push-ups, pull-ups, climbing, lifting weights, or working with resistance bands.
• Bone-strengthening activity, which puts force on your bones, usually through impact with the ground: running, jumping rope, basketball, volleyball or gymnastics.

One activity can count for more than one of these. A hard game of basketball is vigorous and bone-strengthening, because of all the running and jumping. These minutes are part of your 60, not extra on top.

If you're 18, the guidelines for adults apply to you instead; you can find them at Health.gov. And if you're far from 60 minutes right now, moving more than you do today is a real step forward. Lesson 5 explains how to build up safely.

Add up your minutes

A quick way to see where you stand is to count your active minutes for a week. Multiply the number of days you're active by the minutes of moderate-to-vigorous activity you get on each of those days. That gives your minutes a week. Divide by 7 to get your average per day.

The guideline is 60 minutes on each of the 7 days, so the weekly total it adds up to is 7 × 60 = 420 minutes. Try the calculator below. It's a simple check, not a full picture: the guideline is about every day, and it also asks for muscle- and bone-strengthening activity, which a minute count can't show.

Moderate or vigorous? Use the talk test

Moderate activity gets your heart beating faster and makes you breathe harder than usual: brisk walking, an easy bike ride, active chores like raking leaves, or a casual game of catch that keeps you moving.

Vigorous activity makes you breathe hard and fast: running, fast biking, swimming laps, jumping rope, or a competitive game of soccer or basketball.

You don't need any equipment to tell them apart. Use the talk test:

• If you can talk but can't sing, you're at a moderate level.
• If you can only say a few words before stopping for a breath, you're at a vigorous level.
• If you could easily sing, you're at a light level. Light movement is still better than sitting, but it doesn't count toward the 60 minutes.

The same activity can be moderate for one person and vigorous for another, and it can change as you get fitter. The talk test adjusts to you.

Everyday movement counts

Your 60 minutes don't have to come from a sport or a single workout. They can add up across the day, as long as each part is at least moderate:

• Walking or biking to school, practice or a friend's house.
• Being active in PE class.
• Walking the dog briskly, dancing, or playing tag with younger siblings.
• Active chores, like carrying groceries, mowing the lawn or shoveling snow.
• Taking the stairs and moving around between long stretches of sitting.

It also helps to cut back on long periods of sitting, like hours in a row of screens. Getting up to move, even briefly, breaks up that time.

If you have a disability or a health condition, being active is still good for you. Aim to be as active as your abilities allow, and ask your doctor, school nurse or PE teacher which activities are a good fit.

Before you start: gear, warm-up and cool-down

Wear the protective gear your sport or activity calls for, like a helmet for biking or skateboarding, and make sure it fits. Shoes should suit the activity and give your feet support. Bring water, and dress for the weather.

A warm-up is a few minutes of easier movement that gets your body ready: a slow jog, jumping jacks, arm circles, leg swings, or an easy version of the sport itself. It raises your heart rate and warms your muscles gradually instead of all at once.

A cool-down does the reverse. Instead of stopping suddenly, slow down with an easy jog or walk, then do some gentle stretching while your muscles are still warm.

Build up gradually, and rest

Doing too much, too soon is one of the most common ways teens get hurt. When you start a new sport or training plan, begin with shorter or easier sessions and add a little at a time. Your muscles, bones and joints need time to adapt.

Repeating the same motion over and over without enough rest can cause an overuse injury: pain that builds up slowly, often in a shin, knee, heel, elbow or shoulder, and keeps coming back. Mixing different activities and taking rest days help prevent them.

Your body gets stronger during recovery, not only during the workout. That means:

• Sleep. Teens need 8 to 10 hours, as Health Literacy's lesson on sleep, stress and mental health explains.
• Fuel. Regular meals and snacks from all the food groups (lessons 1 and 2).
• Fluids. Drinking before, during and after activity, and more in the heat (lesson 3).

Mild, achy muscle soreness that fades after trying something new is common. Sharp pain, pain in a joint, or pain that gets worse is different: it's a signal to stop.

Heat illness: know the signs

Hot, humid weather makes it harder for your body to cool itself by sweating. Heat illness can affect anyone, including fit athletes, especially at early-season practices before their bodies are used to the heat.

Heat exhaustion signs include heavy sweating; cold, pale, clammy skin; a fast, weak pulse; nausea or throwing up; muscle cramps; tiredness or weakness; dizziness; headache; or fainting. What to do: stop, tell a coach or athletic trainer, move to a cooler place, loosen tight clothing and gear, put cool, wet cloths on the body, and sip water. Get medical help right away if the person throws up, or if the signs get worse or don't improve.

Heat stroke is a medical emergency. Signs include a very high body temperature; hot, red skin that may be dry or damp; a fast, strong pulse; headache; dizziness; nausea; confusion; or passing out. Call 911. While you wait, move the person to a cooler place and cool them with cool, wet cloths or a cool bath. Don't give them anything to drink.

To lower your risk: drink water before, during and after activity; take breaks in the shade; wear light, loose clothing; get used to the heat gradually; exercise at cooler times of day when you can; and speak up as soon as you feel off.

Injuries: when to stop

"No pain, no gain" is bad advice. Stop, tell your coach, athletic trainer or parent or guardian, and get checked by a health professional if you have:

• Sharp or sudden pain, or you heard or felt a "pop".
• Swelling, or you can't put weight on a leg or move a joint normally.
• A joint or bone that looks out of place.
• Numbness or tingling.
• Pain that makes you change the way you run, throw or move.
• Pain that keeps coming back every time you play.

Playing through an injury can turn a small problem into a bigger one. For serious injuries, like heavy bleeding or a bone poking through the skin, call 911; Health Literacy's lesson on emergencies explains how.

Concussion: when in doubt, sit it out

A concussion is a brain injury caused by a bump, blow or jolt to the head, or a hit to the body that makes the head move quickly back and forth. You don't have to pass out to have one.

Signs include headache or pressure in the head, dizziness or balance problems, nausea, blurry vision, being bothered by light or noise, feeling foggy or slowed down, confusion, trouble remembering, or just "not feeling right". Some signs don't show up until hours later.

If you or a teammate might have a concussion: stop playing right away, tell a coach or athletic trainer, and get checked by a health professional. Don't go back in that day, and only return to your sport when a health professional says it's OK. When in doubt, sit it out.

Call 911 or go to the emergency room if the person can't be woken up or is very drowsy, has a headache that gets worse and won't go away, has slurred speech, weakness or numbness, keeps throwing up, has a seizure, passed out, or is acting very strangely.

All bodies are different

Bodies come in many shapes and sizes, and that's normal. Your height, build and where your body stores muscle and fat are shaped a lot by your genes. During the teen years, bodies grow and change, and everyone goes through those changes at their own time and pace.

You can't tell how healthy someone is just by looking at them. Health is about things like how you eat, move, sleep and feel, not about matching one "ideal" body. Athletes show this well: bodies that are strong and healthy look very different from one sport to another.

Your body image is how you see and feel about your body. It's easy to compare yourself with photos online, but many are posed, filtered or edited. If certain accounts leave you feeling worse about yourself, it's OK to mute or unfollow them. And try not to comment on other people's bodies, even as a compliment: you never know what someone is dealing with.

Skip fad diets and extreme rules

A fad diet is a popular eating plan that promises big results with strict rules. Watch for these red flags:

• It promises fast, dramatic results.
• It cuts out a whole food group, or labels foods as "good" and "bad".
• It has rigid rules about what, when or how little to eat.
• It talks about "detoxing" or "cleansing" your body.
• It's selling something, or relies on before-and-after photos and testimonials rather than evidence (Health Literacy lesson 1).

Your body is still growing, and it needs energy and nutrients from a variety of foods, as lessons 1 and 2 explained. Extreme rules can leave you tired, make it harder to focus, and hurt your performance in sports. What works better is steady and flexible: regular meals and snacks from all the food groups, paying attention to when you're hungry and when you're full, and knowing that all foods can fit.

If you think you have a health reason to change how you eat, talk to your doctor first rather than following advice from a video or a friend.

Supplements: ask before you try

Dietary supplements include vitamins, minerals, herbal products, protein powders and "pre-workout" products. Many teens see them promoted as a shortcut to muscle, energy or a different body. Here's what's important to know:

• The FDA does not review dietary supplements for safety or effectiveness before they're sold. The claims on the label haven't been proven to the FDA.
• "Natural" doesn't mean safe. The FDA has warned that some products sold as supplements, especially ones marketed for muscle building, weight loss or energy, contain hidden ingredients that aren't on the label.
• Supplements can interact with medicines (Health Literacy lesson 3 explains interactions).

For most teens, a variety of foods provides what the body needs. Before trying any supplement, ask a doctor or pharmacist. They can tell you whether you need it and whether it's safe for you. FDA.gov and NIH.gov have reliable information about supplements.

When eating or exercise stops being healthy

Sometimes eating or exercise stops being about fuel and fun and starts to feel like pressure. Signs to take seriously in yourself or a friend include:

• Thinking about food, weight or body shape much of the time.
• Feeling guilty, anxious or ashamed after eating.
• Skipping meals or cutting out foods to change your body.
• Exercising even when sick or hurt, or feeling panicked about missing a workout.
• Avoiding meals with family or friends.
• Often feeling tired, dizzy or cold, or having big changes in mood or energy.

Eating disorders are serious illnesses, not a choice or a phase, and they can be treated. They can affect people of any gender, size or background, and getting help early makes a real difference.

If you notice these signs in yourself, talk to a trusted adult or doctor: a parent or guardian, your school nurse or counselor, or a coach. If you're worried about a friend, tell them privately that you care, listen without commenting on their food or body, and tell a trusted adult, even if your friend asks you not to.

If you or someone you know is in crisis, call or text 988, any time, 24 hours a day, 7 days a week. If someone is in immediate danger, call 911.

Looking back over the course

Here's what you've covered:

• Food as fuel: what carbohydrates, protein, fats, fiber, vitamins, minerals and water do for you.
• Meals and snacks: the five MyPlate food groups, half your plate fruits and vegetables, and eating well on a budget and a busy schedule.
• Hydration: water first, pale-yellow urine as a simple sign, and why teens should avoid energy drinks.
• Activity: 60 minutes or more of moderate-to-vigorous activity every day.
• Safety: build up gradually, know the heat and injury warning signs, and when in doubt, sit it out.
• Balance: respect your body, skip quick fixes, and ask for help early.

Everyone has mental health

Health Literacy lesson 5 described mental health as how you think, feel and cope with life. This course goes deeper. Your mental health includes your emotional, psychological and social wellbeing: how you handle feelings, how you make sense of what happens to you, how you get along with other people, and how you make choices.

It isn't something only some people have. Every person you know has mental health right now: your best friend, your teachers, you.

Mental health and physical health are tied together. A bad night's sleep can make you short-tempered; a stressful week can show up as headaches or a sore stomach; a walk with a friend can lift your mood. Taking care of one helps the other.

It changes over time

Your mental health isn't fixed. Like your physical health, it goes up and down: a great week, a rough month, a stretch where everything feels steady. Lots of things push it one way or the other:

• Everyday life: sleep, food, exercise, how busy you are.
• People: friendships, family, a breakup, feeling left out, feeling supported.
• Big changes: moving, a new school, a family change, the loss of someone you love.
• Your body: being sick or injured, and the changes of growing up.

Some of these you can influence and some you can't. Either way, a hard stretch doesn't mean something is permanently wrong with you. It means you're human.

Mental health and mental illness are not the same thing

People often say "mental health" when they mean "mental illness", but they're different ideas.

A mental illness, also called a mental health condition, is a health condition that involves changes in emotions, thinking or behavior, often causing distress or making daily life harder. Anxiety disorders, depression and ADHD are examples. A doctor or mental health professional is the one who can identify a condition, after looking at the whole picture.

Mental health, on the other hand, is something everyone has, and it moves along a continuum, a range with no sharp dividing lines:

• Thriving: you feel mostly like yourself, handle ups and downs, and enjoy things.
• Coping: things are harder, but you're getting through.
• Struggling: worry, low mood or stress are getting in the way of school, sleep or friends.
• Needing extra support: it's hard to get through the day, and it's time to bring in more help.

Here's the key part: the two don't line up neatly. Someone with no mental illness can have a stretch of poor mental health, like after a loss. And someone with a mental health condition that's being treated and supported can spend a lot of time thriving. The continuum describes where someone is right now, not who they are.

Myths that get in the way

A lot of what people believe about mental health isn't true, and those beliefs can keep people from getting help.

• Myth: "Teens are just moody. It's not a real problem." Mood changes are part of growing up, but mental health conditions are real health conditions, and many first show up in the teen years.
• Myth: "Mental illness is rare." Mental health conditions are common. There's a good chance someone you care about has dealt with one.
• Myth: "They could just snap out of it if they tried harder." A mental health condition isn't about willpower or character, any more than asthma is. Nobody chooses it.
• Myth: "People with mental illness are dangerous." Most people with mental health conditions are not violent.
• Myth: "Once you have a mental illness, you'll never get better." Mental health conditions are treatable. With the right support, which can include talking with a counselor or therapist and sometimes medicine prescribed by a doctor, many people feel better and do well.

Stigma, and why words matter

Stigma is negative attitudes, stereotypes or unfair treatment aimed at people because of something like a mental health condition. It shows up in jokes, labels like "crazy" or "psycho", and comments like "only weak people see a counselor." Sometimes people turn it on themselves, which is called self-stigma: "I should be able to handle this alone."

Stigma matters because it makes people hide what they're going through and wait longer to get help. You can push back on it:

• Use person-first language. Say "a person with depression", not "a depressed person" or a label.
• Don't use conditions as adjectives. "I'm so OCD about my locker" turns a real condition into a joke. "I like my locker neat" says the same thing.
• Talk about mental health like physical health. Seeing a counselor is as normal as seeing a doctor for a sprained ankle.

If you're struggling right now, you don't have to wait for a later lesson. Talk to a trusted adult, like a parent or guardian, school counselor or doctor. You can call or text 988, the 988 Suicide & Crisis Lifeline, any time, 24/7. It's free and confidential. If someone is in immediate danger, call 911.

Every emotion is information

All emotions are normal, including the uncomfortable ones. Each one is your brain telling you something:

• Fear or nervousness says "pay attention, this matters or might be risky."
• Anger often says "something feels unfair, or a line was crossed."
• Sadness says "you lost something that mattered," and that you may need comfort.
• Joy and pride point to what you care about and want more of.

Feelings and actions are different things. Every feeling is okay to have; what you do with it is a choice. Feeling angry at a friend is information. Posting something cruel about them is an action, and one you might regret.

You can also feel two things at once. Being excited and nervous before a first day, or relieved and sad when something ends, is completely normal.

Name it more precisely

When someone asks how you are, "fine", "bad" or "stressed" is the usual answer. But those words are blurry. More precise words help you figure out what's really going on and what you need:

• Instead of "bad": disappointed, lonely, embarrassed, guilty, left out, hurt.
• Instead of "stressed": overwhelmed, nervous, pressured, restless, dreading something.
• Instead of "mad": frustrated, annoyed, jealous, betrayed.
• Instead of "good": calm, proud, relieved, grateful, excited.

Each one points to a different next step. "Lonely" might mean texting a friend. "Overwhelmed" might mean making a plan. Many people also find that simply putting a feeling into words makes it feel a little more manageable. It helps to notice where you feel it in your body, too: a tight chest, clenched jaw or knot in your stomach are often your first clue.

What stress does in your body

Anything that puts pressure on you is a stressor: a test, a tryout, an argument, a packed schedule. When your brain spots one, it sets off the stress response, sometimes called "fight, flight or freeze." Your body releases stress hormones, mainly adrenaline and cortisol, and gets ready to act:

• Your heart beats faster and your breathing speeds up.
• Your muscles tense, ready to move.
• You feel alert and focused on the problem.
• Digestion slows down, which is why you might get "butterflies" or a stomachache.

This system is built for short bursts, like jumping out of the way of a bike. Once the moment passes, your body is designed to settle back down. Trouble starts when the alarm keeps going for days or weeks without a break.

Healthy stress vs. harmful stress

Healthy stress is short-term and manageable. The nerves before a presentation or a big game can sharpen your focus and help you rise to the challenge. When it's over, you calm down.

Stress becomes harmful when it's too much, lasts too long, or feels completely out of your control. Chronic stress, stress that keeps going for weeks or longer, can show up as:

• Trouble falling asleep, or waking up still tired.
• Headaches, stomach problems or tight muscles.
• Snapping at people, or feeling on edge all the time.
• Having a hard time focusing, or dropping things you usually enjoy.

You can't get rid of all stress, and you wouldn't want to. The goal is to recover from it and keep it from piling up.

Your coping toolbox

Health Literacy lesson 5 listed some healthy ways to cope. Here's how to match them to what's going on:

• Calm your body: slow breathing with a longer out-breath, moving your body (a walk, shooting hoops, dancing), time outdoors, and enough sleep.
• Tackle the problem: break big tasks into small steps, make a plan, ask a teacher or coach for help.
• Connect: talk to a friend, family member, coach or counselor. Saying it out loud often makes a problem feel smaller.
• Limit what you can't control: draw a circle of control. Put what you can influence inside and what you can't outside. Spend your energy inside the circle, and set limits on the outside stuff, like how often you check the news or refresh your grades.

Some ways of coping feel good for a moment but make things worse later, like avoiding everything, staying up all night or using alcohol or drugs. If you ever feel like hurting yourself to cope, that's a sign to reach out right away. Talk to a trusted adult, or call or text 988, the 988 Suicide & Crisis Lifeline, any time, 24/7. It's free and confidential. If someone is in immediate danger, call 911.

Ups and downs, or something more?

Lesson 2 showed that every emotion is normal, including sadness, worry and stress. Feeling down after a bad grade or nervous before a game is part of being human, and those feelings usually ease within days as things change.

What's different when someone is struggling with their mental health is usually a mix of three things:

• How long the changes last.
• How strong they are.
• How much they get in the way of school, friends, sleep and daily life.

Anxiety and depression are two of the most common mental health conditions, so it helps to know what they can look like. The signs below are general. They're not a checklist to score yourself or anyone else.

Signs of anxiety

Anxiety is a normal emotion: it's the worry or nervousness you feel when something matters or feels uncertain. For some people, though, the worry becomes strong, hard to control and doesn't go away, even when there's no clear reason. That's when it may be an anxiety disorder. Common signs include:

• Worrying a lot, about many things, and finding it hard to stop.
• Feeling restless, keyed up or on edge.
• Trouble concentrating, or your mind going blank.
• Being irritable, or getting tired easily.
• Trouble falling or staying asleep.
• Tense muscles, headaches or stomachaches.
• Avoiding places, people or situations because of fear, like skipping class or not going out.

Some people have panic attacks: sudden waves of intense fear with a pounding heart, shaking, sweating or feeling short of breath. They're very frightening but they pass, and they're worth telling a doctor about.

Signs of depression

Depression is more than feeling sad for a while. It affects how a person feels, thinks and handles daily life. Common signs include:

• Feeling sad, empty or hopeless most of the time.
• Being irritable or quick to anger. In teens, depression sometimes looks more like irritability than sadness.
• Losing interest in things they used to enjoy.
• Sleeping much more or much less than usual.
• Eating much more or much less than usual.
• Feeling tired or low on energy, even after rest.
• Having a hard time concentrating or making decisions.
• Feeling worthless or guilty, or pulling away from friends and family.
• Thinking about death or suicide.

Many of these signs overlap with ordinary stress, not enough sleep, or physical health problems. That's exactly why a professional, not a list, is the one who figures out what's going on.

When to reach out

A simple guide: if signs last about two weeks or more, or get in the way of daily life, it's time to reach out. "Daily life" means things like:

• School: grades dropping, trouble focusing, skipping class.
• Friends and family: pulling away, fighting more, feeling alone.
• Sleep and eating: big changes from what's normal for you.
• Things you enjoy: quitting activities or not caring about them anymore.

This is a nudge, not a rule. You never have to wait: it's always okay to talk to someone sooner.

Some signs never wait. If you or someone you know talks about suicide, not wanting to be alive, or hurting themselves, reach out right away: tell a trusted adult and call or text 988, the 988 Suicide & Crisis Lifeline, any time, 24/7. It's free and confidential. If someone is in immediate danger, call 911.

Getting help is a strength, and don't self-diagnose

Reaching out takes courage. It's the same smart move as seeing a doctor for an ankle that won't heal, and mental health conditions are treatable. Good people to start with:

• A parent, guardian or other trusted adult.
• Your school counselor.
• Your doctor, who can check your physical health too.
• A mental health professional, like a counselor, therapist or psychologist. Lesson 6 looks at what talking to one is like.

You don't need the right words. "I haven't felt like myself lately" is enough to start.

What you shouldn't do is self-diagnose with online quizzes or videos. Signs overlap, some physical health problems can cause similar changes, and a professional asks questions and looks at the whole picture. A wrong label can make you worry more or miss what's really going on. To learn more, trustworthy sites like NIMH.nih.gov (the National Institute of Mental Health) and MedlinePlus.gov are good for understanding, not for diagnosing yourself.

Why friends matter

When teens are going through a hard time, a friend is often the first person to notice, and sometimes the first person they tell. That puts you in a good position to help. It doesn't make you their counselor.

Health Literacy lesson 5 gave you the basics: reach out, listen, take it seriously and involve a trusted adult. This lesson goes deeper into how to do each of those things, and what to do when you're not sure. Your job has four parts: notice, ask, listen, and connect them to help.

Notice, then ask

In lesson 3 you looked at signs that someone may be struggling. With a friend, the clue is usually a change: they stop replying to the group chat, quit a team they loved, seem tired or irritable all the time, or joke about not caring anymore.

You don't need proof before you say something. Pick a private, low-pressure moment, like walking home or shooting hoops, and keep it simple:

• Say what you've noticed. "You've seemed really quiet lately, and you skipped practice twice this week."
• Ask an open question. "How are you really doing?" gets a fuller answer than "You okay?"
• Show you care. "I'm asking because you matter to me."

If they say "I'm fine" but you're still worried, you can say, "Okay. If that changes, I'm here," and check in again in a few days. Asking again later isn't nagging; it shows you meant it.

Listen without judging

When a friend opens up, the most helpful thing is often to listen more than you talk. This is called active listening:

• Put your phone away and give them your full attention.
• Let them finish. Silence is okay; they may need a moment.
• Validate what they feel: "That sounds really hard" or "It makes sense you'd feel that way."
• Repeat back what you heard, so they know you got it: "So it's not just the breakup, it's that you feel like nobody gets it."

Try to avoid lines that shut people down, even when you mean well: "Other people have it worse," "Just think positive," or "You're overreacting." You also don't have to solve their problem. Most people feel better just from being heard.

When it's not a secret you can keep

Some things are too big for a friend to hold alone. If a friend talks about suicide, not wanting to be alive, or hurting themselves, tell a trusted adult right away, even if they asked you not to. That could be a parent or guardian, a school counselor, a teacher, a coach or the school nurse.

If you're not sure whether they meant it, it's okay to ask directly: "Are you thinking about suicide?" Asking calmly and clearly doesn't put the idea in someone's head. It tells them they can talk about it with you. Whatever they say, the next step is the same: connect them with an adult who can help.

Your friend may be upset with you for telling. That's a real risk, and it's worth it. A friendship can recover from hurt feelings. Keeping their safety a secret could leave them without the help they need.

You can call or text 988, the 988 Suicide & Crisis Lifeline, any time: 24 hours a day, 7 days a week, free and confidential. You can call for yourself, or to get advice about a friend, or you can contact 988 together with your friend. You can also chat online at 988lifeline.org.

If someone is in immediate danger, call 911. Stay with them if it's safe for you to do so, and get an adult nearby to help.

Taking care of yourself too

Supporting someone who's struggling can be heavy. You might feel worried, sad, frustrated or even guilty. Those feelings are normal, and they're a sign you care.

• You're not responsible for fixing it. Getting a trusted adult involved is helping. It also means you're no longer carrying it alone.
• Keep doing what keeps you steady: sleep, movement, time with other friends, and the coping skills from lesson 2.
• Talk to someone yourself. A school counselor or trusted adult can support you, not just your friend. You can contact 988 for yourself if you're overwhelmed.
• It's okay to set limits. You can say, "I want to help, and I think we need an adult who knows more than me."

Healthy and unhealthy relationships

Friends, family, teammates and dating partners can be some of the best parts of your life. The same relationships can also wear you down. A useful question is: how do I usually feel around this person?

In a healthy relationship, you feel respected and safe. You can:

• Be honest and disagree without being scared of how they'll react.
• Spend time with other friends and do your own things.
• Say no and have it accepted.

Warning signs of an unhealthy relationship include someone who puts you down, gets jealous when you see other people, checks your phone or wants your passwords, pressures you to do things you don't want to do, or makes you feel you have to "walk on eggshells."

No relationship is perfect, and everyone has bad days. But if you feel controlled, afraid or pressured a lot of the time, talk to a trusted adult. If you're ever in immediate danger, call 911.

Boundaries and saying no

A boundary is a limit you set about what's okay for you: how people talk to you, how you spend your time, what you share, and who touches your stuff or your body. Boundaries aren't walls. They tell people how to treat you well.

Saying no is easier with a few ready-made lines. Be clear and calm; you don't owe a long explanation:

• "No thanks, I'm not into that."
• "I can't tonight. I need some time to myself."
• "Please don't post that picture of me."
• "I'm not sharing my password. That's just for me."

This way of speaking up, honest and respectful at the same time, is called being assertive. People who care about you will respect a boundary, even if they're disappointed. If someone keeps pushing after you've said no, that tells you something important about the relationship.

Respect runs both ways: when someone tells you no, accept it the first time.

Social media and comparison

Social media can help you stay close to friends, find people who share your interests and feel less alone. It can also leave you feeling worse, often without you noticing why.

One reason is social comparison. Most people post their best moments: the trip, the win, the perfect photo. You're comparing your ordinary Tuesday to everyone else's highlight reel. Photos can also be edited or filtered, so they may not even show what really happened.

A few ways to take back control:

• Check in with yourself. After scrolling, ask: do I feel better or worse than before?
• Shape your feed. Mute or unfollow accounts that leave you feeling bad about yourself. Follow ones that make you laugh, learn or feel inspired.
• Turn off notifications you don't need, so your phone isn't deciding when you pay attention to it.
• Spend time offline with people, outdoors or doing something you enjoy.

Screens and sleep

As Health Literacy lesson 5 explained, teens are recommended to get 8 to 10 hours of sleep, and bright screens and busy minds make it harder to fall asleep. Scrolling in bed is easy to lose track of: "one more video" can turn into an hour.

Say your alarm goes off at 6:30 a.m. If you scroll until 12:30 a.m., the most you can sleep is 6 hours, at least 2 hours short of the recommended 8. Less sleep makes stress, low moods and comparison feel even bigger the next day.

Simple fixes: charge your phone outside your bedroom, use a regular alarm clock, and start with a screen-free half hour before bed.

Cyberbullying: what to do

Cyberbullying is bullying through phones, computers, games or social media: mean messages, rumors, embarrassing photos, fake accounts, or leaving someone out on purpose. Because it can follow you home and be seen by many people, it can hurt a lot. It is never your fault.

If it happens to you or someone you know, StopBullying.gov recommends steps like these:

• Don't respond or retaliate.
• Save the evidence. Take screenshots that show the messages, the username, and the date and time.
• Block the person, and report the content or account using the app's or site's reporting tools.
• Tell a trusted adult, such as a parent or guardian or school counselor. Schools can often step in, especially if it involves other students.

If a message threatens violence, tell an adult right away; it may need to go to the police. If it involves a sexual photo of anyone under 18, don't save or forward it. Tell a trusted adult immediately and let them handle it.

If you see someone else being targeted, you can help: don't like or share it, reach out to the person privately, and report it. If cyberbullying leaves you or a friend feeling hopeless, you can call or text 988 any time.

Resilience is a skill

Resilience is your ability to adapt and keep going when life gets hard: a breakup, a move, a family change, a disappointing grade or a loss. Resilient people still feel sad, angry or scared. The difference is that they have ways to cope and people to lean on, so they can get back on their feet over time.

The good news is that resilience isn't something you either have or don't. It's more like a muscle: it grows with practice. Things that help build it:

• Connection. Relationships where you feel cared for are a big part of what helps people through hard times.
• Healthy basics. Sleep, food, movement and time outdoors give you more energy to cope.
• Coping skills. The breathing, breaking-tasks-down and other skills from lesson 2 get easier each time you use them.
• Self-compassion. Talk to yourself the way you'd talk to a good friend: "This is hard, and I'm doing my best," not "I'm such a failure."
• Looking for what you can control. You can't control everything, but you can usually take one small step.
• Purpose. Helping others, a creative project or something you care about can keep you going when things are tough.

Your support system and wellbeing plan

Your support system is the group of people you can turn to. It helps to have more than one person, and more than one kind of support: someone to have fun with, someone to vent to, and an adult who can help with bigger problems.

A wellbeing plan puts what you know about yourself on paper, so it's ready when you're stressed and it's harder to think clearly. It isn't a test or a diagnosis. It's just a personal reminder of what keeps you well and who you can go to.

Who can help, including right now

Different people help in different ways, and you can reach out to more than one:

• Trusted adults: a parent or guardian, relative, teacher, coach or school nurse. They can listen, help you think through what's next and connect you with more support.
• School counselors: trained to help with stress, friendships, family problems and feeling down. They can also point you to other help.
• Doctors: your regular doctor can check how you're doing physically and emotionally, and can give you a referral to a specialist.
• Therapists and counselors: mental health professionals trained to help people understand their feelings and build skills to cope.

You don't need to know exactly what's wrong before you go. "I haven't been feeling like myself" is a perfectly good way to start.

If you need help now, call or text 988, the 988 Suicide & Crisis Lifeline, any time: 24 hours a day, 7 days a week. It's free and confidential. You don't have to be thinking about suicide. You can reach out if you're struggling, overwhelmed or worried about someone else, and a trained counselor will listen and help. You can also chat at 988lifeline.org.

If someone is in immediate danger, call 911.

For reliable information about mental health, look to official sources like NIMH.nih.gov (the National Institute of Mental Health), CDC.gov and MedlinePlus.gov.

What talking to a professional is like

Many teens feel nervous before seeing a counselor or therapist for the first time. Every professional works a bit differently, but in general:

• It's a conversation. They'll ask about what's been going on, like school, sleep, friends and family. You can share at your own pace.
• You can ask questions too, such as how often you'll meet or what the sessions will be like.
• It often takes a few visits to feel comfortable and to start noticing changes. That's normal.
• Fit matters. If it doesn't feel right with one person after giving it a fair try, it's okay to ask a parent, doctor or counselor about seeing someone else.

Privacy. What a professional keeps private, and what they share with a parent or guardian, depends on the situation and on your state's rules, which vary. It's a good idea to ask at the first visit: "What stays between us?" But if someone's safety is at risk, they will act to keep that person safe.

Looking back over the course

Across these six lessons, you've learned that everyone has mental health, and that it changes over time (lesson 1). You've practiced naming emotions and coping with stress (lesson 2), and learned the signs that it's time to reach out (lesson 3). You've seen how to help a friend and when a secret can't be kept (lesson 4), and how relationships and digital life affect how you feel (lesson 5).

The thread through all of it: mental health conditions are common and treatable, getting help is a strength, and you never have to figure it out alone.