"The mind and the body are like parallel universes. Anything that happens in the mental universe must leave tracks in the physical one", - Deepak Chopra.
Are you feeling stressed? Emotional health has profound effects on physical health and overall well-being. We know that depression is a risk factor for diabetes and coronary artery disease (1, 2). We also know that stress can affect our neuroendocrine (hormone) balance and suppresses our immune system (3). So, why is it that when we are stressed we are less likely to participate in healthy behaviors even though these behaviors can in turn improve mood and reduce stress (4)?
Try out some of these well-proven non-pharmacologic strategies to help improve mood and reduce stress listed below.
1. Participate in regular exercise. Physical inactivity or sedentary behavior is an independent risk factor for depression. Have we beaten this to a pulp yet? Click here for more info.
2. Practice mindfulness and other relaxation therapies. Mindfulness may not be in your current vocabulary but I would encourage you to make space for it. The simplest definition of mindfulness is to be fully aware and present in the moment without judgment of what is happening. Mindfulness practice acknowledges the relationship between the mind and body and helps to create an awareness of stimuli in your environment and a similar awareness of your responses to these stimuli. It encourages you to create experiences by acknowledging the experience without striving or judgment. Mindfulness focuses on openness, patience, an attitude of self-reliance, and acceptance of failure. Mindfulness-Based Stress Reduction (MBSR) is an intensive training developed by Jon Kabat-Zinn at the Center for Mindfulness, University of Massachusetts Medical School. The program is designed to create awareness and an ability to access our innate capacity for health, happiness, and growth. If this concept is new to you, Headspace not only offers a free trial for new users but they do a great job of breaking it down for you in beginner terms. There are several other great apps out there to help you get started if you're interested. Learn more here. The Wild Health Podcast, Episode 164, is a great Introduction to Mindfulness. Learn a little more about breathwork and how it may affect your mental health. Again, I really like Episode 171 and 126 on Breathwork brought to you by the Wild Health Podcast.
3. Practice meditation. Meditation typically guides your mental focus inward with a certain letting go of your surroundings. This is different than mindfulness which encourages you to fully engage in the present creating an awareness of your body and its surroundings. In meditation, there is typically a single focus to your practice such as awareness of breath, a mantra, or a guided practice. In encourages you to let go of any thoughts that may come and go and in doing so allows you to experience them without judgment, gaining a sense of perspective, emotional balance, and a sense of calmness. Meditation can lower the negative impacts of stress and abdominal breathing alone has been used to minimize stress (5). It can also lower your heart rate, respiratory rate, blood pressure, and cortisol levels...all without physical exercise!! If this concept is new to you, Headspace not only offers a free trial for new users but they do a great job of breaking it down for you in beginner terms.
4. Eat well. Nutrition can play a role in mental health and mood disorders. There is data to suggest that a diets rich in trans fats are associated with higher rates of depression (6). Diets that are also high in fried foods, refined grains, and added sugar have been associated with increased rates of depression and anxiety (7). Omega-3 supplementation (fish oil) may be linked to lowering depressive symptoms in bipolar and other cognitive disorders (8, 9, 10). According to a study done in medical students, there may also be a link to lowering anxiety (11). There is no well-defined amount of Omega-3's designated for consumption on a daily basis but I typically recommend about 1000 mg of EPA and 500 mg of DHA.
5. Make a conscious effort to have an abundance of positive emotions on a daily basis in all situations. Joy. Contentment. Happiness. Love. Pride. Peace. These are just a few. Have you ever met someone who is so positive that you cannot help but be positive when you're around them? These people are intoxicating. For some people, this takes a lot of effort but it is well-proven that the more positive emotions you experience, the more resilient you will be when the going gets tough (12). The ideal ratio of positive to negative emotions is 3:1. Check out this short video on positive emotions. Try taking this resiliency quiz - www.positivityratio.com
6. Be grateful. Focusing on the great things in your life and feeling a sense of appreciation helps to bring to light those positive emotions we just listed. Every morning when I wake up, I write down THREE things I am grateful for. It is amazing how trained we are to think on the bad things or the things that are stressful rather than focus on the good. This morning I was grateful for: the fact that it was Friday, air-conditioning in my home when the high will be 102 degrees today, and my coffee. Yes, my coffee!! It is so easy to overlook the good things in our lives - things as simple as coffee or running water or that you have good neighbors. Don't overlook those small things. Keep a gratefulness journal. Write down three things you are grateful for when you wake up and when you go to bed. You will be amazed at how this will improve your outlook for the future and give you an abundance of positive emotions. Check out this quick video. Curious about the science behind gratefulness and how it can impact our health? Click here.
7. Increase awareness of your strengths. This will also help to increase your positive emotions (13). What are your strengths? Do you know them? Do you focus on them? There are six broad categories of core virtues. They are: wisdom and knowledge, courage, humanity, justice, temperance, transcendence. There are several virtues within each category. I recommend heading to: www.viacharacter.org to dive a little deeper into this concept. Once you know your strengths, you can utilize them to make a positive impact.
6. Build positive relationships and social support. Create a list of needs and determine those around you who can help with those needs. If you don't have someone in your immediate social circle that can help with those needs, identify a person or group of people using community resources, online resources, or medical providers who might be able to help with that need and how you might approach them to help fill that gap. Positive connections with others can lower the inflammatory response which has been associated with several different chronic diseases.
7. Practice kindness. Volunteer for meaningful causes. Help someone in need. Give to worthwhile causes. Kindness safeguards against stress.
8. Participate in creative pursuits such a dance, playing a musical instrument, or creating art and spend regular time in nature. All of these have been shown to reduce stress (13).
9. Participate in spiritual and religious activities which have been shown to limit emotional distress and improve well-being (14, 15).
10. Get your zzzz's. Sleep restoration is important in improving your mood.
*If you have concerns about your mood or level of stress that cannot be adequately relieved with non-medical interventions, please reach out to your medical provider for additional resources.
References:
1. Tabak, A.G. et al., Depression and type 2 diabetes: a causal association? Lancet Diabetes Endocrinol, 2014. 2(3): 236-45.
2. Zellweger, M.J., et al., Coronary artery disease and depression. European Heath Journal, 2004. 25(1): 3-9.
3. Mariotti, A., The effects of chronic stress on health: new insights into the molecular mechanisms of brain-body communication. Future Science OA, 2015. 1(3): FS023.
4. APA. Key Findings Stress in America. 2010 (cited 2017 9/9); Available from http://www.apa.org/news/press/releases/stress/2010/key-findings/aspx.
5. Goyal, M., et al., Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med, 2014. 174(3): 357-68.
6. Sanchez-Villegas, A., et al., Dietary fat intake and the risk of depression: the SUN Project. PLoS One, 2011. 6(1): e16268.
7. Jacka, F. N. et al., The association between habitual diet quality and the common mental disorders in community-dwelling adults: the Hordaland Health study. Psychosom Med, 2011. 73(6): 483-90.
8. Leung, B.M. and B.J. Kaplan, Perinatal depression: prevalence, risks, and the nutrition link-a review of the literature. J Am Diet Assoc, 2009. 109(9): 1566-75.
9. Bodnar, L.M. and K.L. Wisner, Nutrition and depression: implications for improving mental health among childbearing aged women. Biol Psychiatry, 2012. 17(12): 1272-82.
10. Stoll, A.L., et al., Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry, 1999. 56(5): 407-12.
11. Kiecolt-Glaser, J., et al., Omega-3 Supplementation Lowers Inflammation an d Anxiety in Medical Students: A randomized controlled trial," Brain, Behavior, and Immunity, 2011. 25 (8): 1725-34.
12. Fredrickson, B., Positivity: Groundbreaking Research Reveals How to Embrace the Hidden Strength of Positive Emotions, Overcome Negativity, and Thrive. 2009., New York: Crown.
13. Kelly, J and Shull, J. Foundations of Lifestyle Medicine: The Lifestyle Medicine Board Review Manual. 2nd Edition. 2019.
14. Moritz S, Quan H, Rickhi B, Liu M, et al., A home study-based spirituality education program decreases emotional distress and increases quality of life--a randomized, controlled trial. Altern Ther Health Med, 2006. 12(6): 26-35.
15. Kreitzer MJ, Gross CR, Waleekhachonloet OA, et al., The brief serenity scale: a psychometric analysis of a measure of spirituality and well-being. Holist Nurs, 2009. 27(1):7-16.
Emotional Health