Should I stay in this relationship? Should I leave my job? Should I keep hanging with this same group of friends?

For a lot of women in their twenties and thirties, the weighty but unknown possible effects on future outcomes in our lives make some life choices feel overwhelming. What is the right choice? It can seem impossible to decide, when we don’t know what consequences that choice might have. Not only did I experience this in my early twenties as I debated whether to go ahead with an engagement I wasn’t sure about, I have known a number of female peers who face indecision when it comes to decisions such as whether to move cities for a different job, move in with someone or move out, accept an engagement or get married, or even spend most of your time with the same group of friends.

Often, when we have questions like this, we turn to our friends. “When you know, you know,” some friends say about how to tell if your man is “the one.” But I remember being befuddled when I didn’t know. What then? From my experience, I came to believe that “when you don’t know, it’s probably ‘no.’” Indeed, some research has found that when women have doubts on their wedding day, it correlates with greater marital problems later in their relationship, while wedding-day jitters for men are less meaningful.

If you’re feeling uneasy about a big decision, it can be tough to know whether it’s the normal unease that comes with a healthy choice that pushes you out of your comfort zone or a red flag. Does your anxiety about a decision mean “run for the hills!” or “go for it!”? To find some clarity, I asked two psychotherapists, both contributors at Verily, for their thoughts and found there are indeed ways to find answers about what is best for you—no matter what choice you’re assessing in your life.

What factors can help us identify if we need to reassess some aspects of our lives?

Interpersonal therapist Anita A. Chlipala, LMFT shared with me measurable ways to note if your actions and decisions are going in the direction of what’s best for you or the opposite. “Identify changes in typical routine,” she told me by email. If “you can’t get out of bed in the morning at the normal time, you stopped working out, and you are drinking more often,” these are signs that something is not right.

Also take note if “you have more anxiety than usual.” Chipala noted that, “some anxiety is normal after a life change or a start of a new relationship” because “there is some uncertainty and you don’t know if things will work out. But if the anxiety gets worse over time, it could be a sign that something isn’t working and there may need to be another change.”

“Look at how often you find yourself complaining more and more to family and friends about your situation or your partner,” she told me. “Relationships aren’t without complaints, but pay attention to whether you have more to complain about rather than celebrate.”

Lastly, Chipala noted, it’s a red flag “if you find yourself trying to exert control” over the situation, because you might be trying to force your foot into the wrong shoe, trying to force a situation to be a better fit, when it naturally isn’t. “Sometimes when a person feels like things aren’t going according to plan or feel an increase in anxiety, they try to make themselves feel better through control. Unfortunately, they usually focus on controlling others versus focusing on what is in their control.”

Therapist Julia Hogan, LCPC shared with me a number of questions you can ask yourself to find “measurable factors” about whether a decision you’re making is right for you:

  • How is my mental health right now?
  • How is my physical health right now?
  • Does my life feel meaningful?
  • What energizes me, and is this part of my life right now?
  • Do I have any symptoms of burnout?
  • Why am I making this particular decision? Am I motivated out of fear or because I am pursuing something I want/is good for me?
  • Am I making this decision because it’s “easy” or because it’s what is best for me?

If you are struggling with a decision, consider sitting down with a journal and answering these questions for yourself. Writing by hand on paper can give you space to contemplate, uninfluenced by screens, and also give you the space to encounter your deeper feelings, hopes, and dreams. Once you’ve done this, read over your answers, and take a moment to reflect on whether your choices are ones that are healthy and generous toward yourself.

What are some indicators that you are taking the right path?

I asked both therapists for markers that a person can use to self-evaluate if they are functioning well and at their best. Chipala said, “One marker is to look at your thoughts—are they more positive or negative? When my clients struggle, they have a more difficult time playing devils’ advocate with themselves” or giving themselves the benefit of the doubt. “They believe the negative more often than usual, where before they were able to focus on the positive.”

Chipala also noted you can “monitor how much you drink. Some people struggle with coping and turn to alcohol as a stress relief. You can measure if there’s an increase in your drinking from what is your ‘usual’ intake.”

In addition, Chipala says, “sleep can be a good indicator of how well you are functioning. Keep track of how often you are waking in the middle of the night due to worry or anxiety, or how long it takes you to fall asleep. There are many apps that can do the work for you and determine the quality of your sleep.” Overall, taking these indicators seriously is like listening to and being a good friend to yourself. As is often the case with mental health and self-care needs, when you respect your needs, you are serving not only yourself but those you care about.

“Generally assessing your mental, physical, and relationship health is a great way to self-evaluate” if you are functioning well on all cylinders, Hogan told me. “If you notice any signs of stress, worry, depressed thinking/negative thoughts, low motivation, irritability, agitation, unresolved trauma, unresolved feelings, trouble sleeping, difficulty concentrating, appetite changes, energy changes, people-pleasing behaviors, struggling with boundaries, etc., I would encourage you to address these before making any big decisions.”

Hogan adds, “and there is the classic advice to never make a decision when you are hungry, angry, lonely, or tired (HALT). Address those first so you are in a better and more authentic frame of mind.”

Most people want to find a state of peace and happiness with their life choices, but if you’re overlooking indicators of problems, it’s worth remembering that overriding your needs won’t serve you well, which won’t help you in your efforts to serve others you care about.

Are you on any medications or dealing with health conditions that could affect your mental clarity?

On a practical level, it’s also worth considering whether you have a health condition or medication that may be making decisions harder for you. If you haven’t seen a general practitioner in a while, it’s worth setting up an appointment to tell them all your current symptoms as well as medications you may be taking. Some health conditions can affect your energy level or mental health, and it’s worth identifying and treating them before ascribing other meanings to your state of feeling “off” or “not yourself.”

Some common medications can affect mental clarity. Many women cite that after getting off birth control and ditching the synthetic hormones, they feel greater mental clarity. The most highly prescribed drug, the birth control pill, and similar hormonal contraceptives like the patch, shot, vaginal ring, implant, or hormonal IUD, all come with potential side effects of mood changes, depression, and anxiety. Lisa Hendrickson-Jack, author of The Fifth Vital Sign and creator of the Fertility Friday podcast, told Natural Womanhood in a recent interview, “If you search whatever brand of hormonal contraceptive and you look in the insert and you read it, mood changes are there, anxiety and depression sometimes are there—sometimes it’s under the label of ‘mood changes,’ but it’s there . . . the manufacturer has it listed as a potential side effect.”

One reason women switch from pharmaceutical methods of birth control to evidence-based fertility awareness methods is to rule out a reason for their mood swings and feel more themselves. When it comes to relationship clarity, hormonal contraceptives can be disruptive as well. Birth control has been found to affect one’s attraction level to one’s partner, making you more attracted to men you’re less compatible with, or less attracted to the love of your life.

On the other hand, sometimes medicine or other medical intervention is what we need to regulate our hormones or brain chemistry to improve our mood. For example, women are more likely than men to be diagnosed with thyroid conditions, and anxiety and depression can be common symptoms when the thyroid is not balanced. Additionally, polycystic ovary syndrome (PCOS) can be linked to, “low self-esteem due to symptoms like unwanted hair growth, obesity, and acne,” which in turn, “can account for anxiety symptoms as well as social anxiety in women.”

Out of the fog, into the clear

Whatever decision you are facing, it can be normal to experience stress and overwhelm when making choices that appear to affect the rest of your life. But by taking one deep breath at a time, monitoring these measurable factors that indicate wellness, and prioritizing your health, you can advance on your journey with greater confidence that the direction you’re taking is the best one for you.