ChangIng our LIfestyles to OptImIze Our Mental Health
Hey, VegMichigan friends! I hope you are all doing well and enjoying the warm Fall days and our beautiful Michigan scenery. Warm days in October always feel like a gift from nature. I hope you enjoyed last month’s post about “The Blue Zones”. I love this book because it describes common lifestyle habits of some of the longest-living people in the world, and how they make these habits a part of their culture. September’s post reviewed Blue Zone lifestyle habits related to diet, exercise, and stress reduction, specifically. I also discussed some ways we can create our own Blue Zones at home by forming a culture of health for ourselves and our families.
This month, I want to talk about mental health.
As a family medicine doctor, anxiety and depression is a significant part of what I see on a regular basis. As we make our way through 2020, it has become even more prevalent. Recent CDC data suggests about one out of every three Americans are showing signs of anxiety or depression, and this is a significant increase from last year. Everyone is facing a unique struggle of their own right now, in one way or another. I don’t need to list the many things going on that could be affecting our mental wellness, but stress, anxiety, worry, and negativity seem to be affecting so many. So let’s start October off right and talk about some lifestyle-related things we can do that may help maintain or improve our mental well-being.
The Gut – Our “Other braIn”
A hot topic in medical research in the last several years is understanding the connections between the gut and the brain. We are discovering so much about the complex interactions between the two systems. Have you ever experienced “butterflies” in your stomach over something, or someone? Have you ever been so nervous that you lost your appetite, or had an upset stomach? How about that gnawing stomach pain when times are tough or stressful? These things occur because what happens in the brain affects the GI tract. We are also finding that what happens in the gut affects the brain, as well.
Did you know the lining of our GI tract has over 100 million nerve cells, otherwise known as the enteric nervous system? It serves many roles such as swallowing, breaking down food, nutrient absorption, and elimination. These nerve cells aren’t capable of creating thoughts or memories like brain cells do, but they are capable of communicating back and forth with the brain. The more we learn about this complex communication, the more it explains why fueling our GI tract with the right nutrients helps prevent and treat disorders occurring within the brain, such as anxiety and depression. It also explains why studies show that antidepressants can improve symptoms of irritable bowel syndrome; and conversely, treatments like cognitive behavioral therapy have been shown to improve functional bowel issues.
Inside the GI tract are over a hundred trillion good bacteria that provide a foundation for many aspects of our overall health. These bacteria do the work of regulating our digestion and metabolism. They extract vitamins and other nutrients from the food we eat and turn it into things the body can use. They impact our immune system and protect us from pathogens trying to enter the body through the wall of the gut. Interestingly, gut bacteria also help regulate processes such as cognition, memory, and mood through the formation of neurochemicals utilized by the brain. One example is serotonin, an important neurotransmitter that regulates both mood and gastrointestinal function. As you may know, many common antianxiety and antidepressant medications work by increasing serotonin levels in the brain. Interestingly, the nerve cells in the GI tract are responsible for producing 90-95% of the serotonin in our bodies!
Why is this important? The food we choose to eat is the fuel that enables our microbiome to perform essential functions that help keep our body and mind functioning optimally. It makes sense that if we fuel ourselves with unhealthy foods, our GI tract will not be able to perform these functions effectively. There is a growing amount of research suggesting that people with diets consisting largely of fresh, whole foods like fruits, vegetables, legumes, and whole grains have lower incidence of mental health conditions like anxiety and depression. This is another reason why a plant-based or plant-strong diet is so beneficial to our overall health. Take a look at this additional information by the Physicians’ Committee for Responsible Medicine about foods that boost the mood.
Get MovIng to boost Your Mood
If you’ve ever taken time out of a busy or stressful day to go for a walk or a jog, go to the gym, or another physical activity, you may have noticed you felt more calm, recharged, and mentally clear afterward. Take a look at this information from the CDC about the many beneficial effects exercise has on our brain and mental health:
1. Exercise is a known stress reliever.
2. Exercise provides a boost of neurochemicals that relaxes us and improves our mood.
3. Exercise increases serotonin in the body which can also help with anxiety and depression.
4. Exercise has been shown to improve our cognition and memory. In kids, it has been shown to improve processing speed, executive functioning, and academic performance.
5. Exercise also helps improve our sleep quality, which is very important for mental health.
A study published in 2007 by Blumenthal et al investigated the effects of aerobic exercise compared to antidepressant medication and placebo for treatment of major depressive disorder. After 4 months, a total of 41% of patients receiving either treatment reported remission of symptoms. The number of patients who achieved remission through a dedicated aerobic exercise program was comparable to those who received medication. The data suggests that aerobic exercise could be an effective treatment, either by itself or as an adjunct therapy, for major depressive disorder. Of course, deciding on the treatment plan best for you is something you’d want to discuss with your doctor. Typically, when my patients prefer to try a dedicated lifestyle approach first, I’m all for it.
Laughter Is Good MedIcIne:
It’s an old proverb that has a lot of truth to it. You know those once in a while times when something is so funny, you cannot stop laughing? The kind that brings tears to your eyes and makes your cheeks and stomach hurt?
What do we always say after those times? “Whew, I needed that!”
It feels so good to laugh like that! Have you ever heard of laughter yoga, where groups of people get together for the purpose of laughing together for health benefits? It’s really a fantastic idea, when you take a deeper look into all the physiologic benefits that laughter provides:
1. Laughter requires deep inhalation and exhalation, as well as use of the diaphragm. This type of breathing has numerous positive effects on stress, anxiety, and overall mood.
2. Laughter increases oxygen and circulation throughout the body.
3. Laughter has been shown to significantly decrease the amount of the stress hormone cortisol circulating throughout the body.
4. Laughter can lower your blood pressure.
5. Laughter has been shown in some studies to increase tolerance to pain.
6. Laughter is thought to improve immune system function.
In the book The Blue Zones, the region of Sardinia, Italy, has roughly ten times more centenarians per capita than here in the United States. In addition to a plant-strong diet, lots of daily walking, social connection, and harvesting their own food, they are also well-known for having a strong sense of humor. Sardinian men have a historical tradition of gathering in the streets every afternoon to laugh, both with and at each other. This is their unique way of relieving stress, celebrating life, and maintaining social connection.
So don’t forget to laugh, as often as possible. Work on developing your own sense of humor, just as you would work on improving exercise, healthy eating habits, or mindfulness. You can intentionally watch a funny movie or a comedy show. Get together with loved ones to reminisce about funny old stories or photos. Get a group of people together to play a funny game (there are so many games these days). Tell jokes to people, or play pranks on your friends. Look around you all the time for things to laugh about. During these tough times, the laughs that make our cheeks and abs hurt and bring tears to our eyes are so great for our wellness. For me, I’m also going to make it a point to try laughter yoga sometime. It sounds so fun!
“Laughter is the tonic, the relief, the surcease for pain.” – Charlie Chaplin
develop Your Sense of purpose:
What does the word “purpose” mean to you? Webster’s dictionary defines purpose as “something set up as an object or end to be attained.” Richard Leider, author of the book “Life Reimagined,” once said “The equation for purpose is G+P+V=P. (Gifts, plus Passion, plus Values, equals Purpose).” Personally, I think purpose is a little deeper than either of these.
Purpose helps guide our life decisions. It influences our behavior; it helps us create and achieve goals; it provides meaning, motivation, and inspiration; and it gives us a sense of direction. For some people it’s related to a career, volunteer work, or service to others. Others find purpose in personal connection or responsibility to family, friends, community, or animals. Some find meaning through spirituality or a specific religion. For most of us, it’s a combination of things. Like a fingerprint, everyone has a unique life purpose of their own. Purpose is also dynamic – what gives us purpose and meaning can grow and change based on our life experiences. We often see this when people experience life-changing events, and they discover a new sense of purpose in giving back or helping others through a similar situation.
The Health and Retirement Study is a longitudinal study that has surveyed a sample of about 20,000 Americans over age 50 every two years since 1992. Researchers at the University of Michigan analyzed data from this study to determine if there was an association between life purpose and longevity. They used a cohort of 6985 individuals who completed the questionnaire in 2006. As you might expect, the results concluded that having a strong sense of purpose was associated with decreased mortality. This data suggests that developing a sense of purpose may have major health benefits over the long run.
Maintaining purpose and meaning in our lives does not come automatically. It is a practice, just like exercise, meditation, and a healthy diet. If we want a life filled with purpose and meaning, we need to work consistently toward discovering and developing a sense of what makes us feel contentment, what defines who we are, what excites us, and what drives us to get up and go every day. If you are interested in taking a deeper look into this topic for yourselves, here are a few tools that might help you get started:
1. Oprah has a nice quiz to guide you in developing purpose and meaning in your life: http://www.oprah.com/omagazine/exercises-for-finding-your-purpose
2. Some of my favorite books I’ve read about this topic include “The Motivation Manifesto” by Brendon Burchard, “Start Something That Matters” by Blake Mycoskie, “You Are A Badass” by Jen Sincero, and “The Art of Work: A Proven Path to Discovering What You Were Meant to Do,” By Jeff Goins.
3. Podcasts: There are so many great podcasts on this topic as well. Brene Brown, The Good Life Project, Happier with Gretchen Rubin, and Jack Canfield’s “Fulfilling Your Soul’s Purpose” episode on Oprah’s SuperSoul Conversations podcast are a few examples.
4. Write down, either in a journal, on your phone, etc., the 3 best things about your day, every single day. After some time, take a look at all the things you’ve written down and try to identify patterns about what makes you happiest. What separates your awesome days from mediocre days? Chances are you’ll find some clues if you start keeping track.
Stay SocIally Connected:
One of the biggest reasons why the pandemic has been so hard on people is the social isolation. We now recognize more than ever how social connectedness impacts our overall health. Studies indicate that social isolation is associated with poor health outcomes such as increased risk for premature mortality, coronary artery disease, stroke, and hospital readmission following myocardial infarction. In terms of mental health, individuals lacking social connection experience significantly higher rates of depression, stress, anxiety, and suicide ideation. Being isolated is also associated with cognitive disorders such as dementia. Does the pandemic have you feeling isolated or lonely? Here’s a few things that might help you increase your social connectedness (many can even be done from home):
1. Start by saying hello: An kind gesture people seem to be moving away from! Say hello to your neighbors, people at coffee shops, and greeters or cashiers at your grocery store. Say thank you to your sanitation workers and mail carriers. Ask them how they are doing. You might start a conversation or hear a story that makes your day, or you might make theirs!
2. Look for ways to help others: This is one of my favorite parts of social connectedness. Offer to help someone carry something heavy. Drop off a care package to a friend or relative. Write letters, post cards, or emails to people you care about. If you are comfortable being around others, volunteer for something that does good in your community, like a school function, animal shelter, VegMichigan event, or a food pantry. It is rewarding to serve and it builds up your social network.
3. Reconnect with people: For the most part, I think social media causes more harm than good in terms of our collective mental health. However, one good thing it does is allow us to reconnect easily with people from our past, or people it might be difficult to stay in contact with otherwise. Strike up a conversation with an old friend or a family member you’ve lost touch with to let them know you are thinking of them.
4. Shop local: Local small business owners are seriously some of the most friendly people, and notorious for striking up conversation. They value their customers so much and they want to get to know us. Plus, it’s nice to shop somewhere where you are remembered! Think coffee shops, bakeries, hardware stores, our many local vegan establishments, or farm markets, for example.
beyond LIfestyle Changes:
Lastly, sometimes mental health issues go beyond lifestyle modification, and medications and professional interventions like counseling are necessary. In these instances, please seek out the help of a medical professional. We are here for you and we are happy to help. In an emergency or crisis situation, here are some resources to get some help:
– Call 911
– Michigan 2-1-1 offers a very wide range of services, from addiction, to pregnancy, to mental health, to housing and shelter: Dial 2-1-1 or text your zip code to 898211
– National Suicide Prevention Lifeline: 1-800-273-TALK (8255) for English, 1-888-628-9454 for Spanish
– National Domestic Violence Hotline: 1-800-799-7233 or text LOVEIS to 22522
– National Child Abuse Hotline: 1-800-4AChild (1-800-422-4453) or text 1-800-422-4453
– National Sexual Assault Hotline: 1-800-656-HOPE (4673)
– Veteran’s Crisis Line: 1-800-273-TALK (8255) or text: 8388255
I hope these suggestions are helpful, either for you or for someone you care about. If times are tough for you right now, just remember that life has a tendency to ebb and flow. We will get through this together, and it will get better. Remember to laugh, be kind, say hello to people, get outside and move around, enjoy the many gifts Michigan has to offer this time of year, and eat lots of plant foods! If I can help any of you with anything, don’t hesitate to reach out to me. Enjoy the Fall sunshine and I will be looking forward to next month’s discussion!