Ross W. Davidson

   Licensed Clinical Mental Health Counselor

   Masters Licensed Alcohol and Drug Counselor

How’s your mental health?

Our mental health has a status, just as our physical health. Even if we are not physically ill, many of us go to the gym, go hiking or kayaking or participate in some other activity. Most of us don’t do these activities because we are ill and want to get better. We do them to maintain our health and to feel even better. Similarly, even if we are not mentally ill, we think about ways to feel happier, more fulfilled, and closer to our loved ones.

Below we will consider four easy fixes to improve our mental health, whatever its status. I call them “easy” because the cost, what you will have to do to benefit from these activities, is minimal, yet the benefits are sizable.

The four activities are exercise, improving sleep, meditation and nutrition. I will discuss each of these in turn, emphasizing the benefits to your mental health with the relative cost necessary to achieve the benefits. At the end of each section, I’ve provided a chart summarizing the costs and benefits for quick reference.

Exercise

Just 30 minutes of aerobic exercise, three times a week, will enhance our sleep, our interest in sex, our physical and mental energy, and endurance. Our mood will improve and likewise our mental alertness and cognitive functioning. We can reduce stress, weight, cholesterol and improve cardiovascular fitness with exercise.

Breaking up the 30 minutes into 10 minute intervals is as effective as 30 minutes straight. Examples of aerobic exercise include walking, dancing, gardening, swimming, jogging, and cycling. Perhaps singing in a choir or playing with your children or grandchildren outside would work as well. Perhaps something you enjoy qualifies for aerobic exercise, but you just haven’t thought of it as exercise. There are hundreds of exercise videos on YouTube alone, if you need inspiration.

How does just 30 minutes of exercise, three times a week, give us all of the above benefits? Aerobic exercise increases blood circulation to the brain generally and influences the Hypothalamic-Pituitary-Adrenal axis (HPA). The HPA Influences the physiologic reaction to stress, connecting to the limbic system which governs mood and motivation. The HPA connects to the Amygdala which generates fear in response to stress, and the Hippocampus which is involved in the formation of memory as well as mood and motivation. Exercise releases “feel good” chemicals: neurotransmitters and endorphins like serotonin, norepinephrine, and the brain-derived neurotrophic factor (BDNF) which effects the longevity of brain cells and can improve symptoms of dementia. Exercise increases body temperature and reduces stress chemicals in the body.

Exercise can be an effective distraction. It can improve self-efficacy (the feeling that you can do things), self esteem, and increase social interaction. Reduces “Metabolic Syndrome,” weight gain side effects of some psychotropic medications.

Sleep

The average adult needs 7-9 hours of sleep a night. Toddlers, ages 1-3 years need 12-14 hours nightly; pre-schoolers (3-5 years old), 11-13 hours; School-aged children (5-12), 10-11 hours; teens (13-18), 8.5 to 9.25 hours.  Anything less can trigger sleep deprivation. In other words, it is easier to become sleep deprived than one thinks. Sleep deprivation can cause and aggravate symptoms of depression and mania and visa versa. Sleep deprivation can cause irritability, emotional lability (unstable mood), and depressed mood. Not getting enough sleep can affect your memory and ability to learn. In teenagers, not enough sleep can contribute to acne as well as aggressive or inappropriate behavior.

Getting enough light during the day, and dark during the night, plays a big role in regulating our sleep cycle, otherwise known as the circadian rhythm (which is naturally 24.2 hours long). The eyes are used for seeing, of course. Light enters the eyes and visual information stimulates the rods and cones which in turn stimulate the optic nerve and eventually the information is relayed to and processed in the visual cortex of the brain.

However, light perceived by the eyes also stimulates the suprachiasmatic nucleus (SCN) in the hypothalamus where hormones are regulated. Light stimulating the SCN reduces the production of melatonin, the sleep hormone, in the pineal gland during the day, which means more melatonin is produced at night, helping you sleep. If you have a thyroid abnormality, this could also interrupt the production of melatonin.

There are many other hormones, enzymes and neurotransmitters, such as dopamine, norepinephrine, glutamate, and GABA, at play as well. Light, especially early morning light, effectively tell the brain, “It’s time to wake up,” to be awake. Enough light and time awake during the day sends a message to the brain that we’ve been awake long enough, turn on the melatonin because now it’s time to sleep. In other words, we need to get enough day light to sleep well. Half a million Americans suffer Seasonal Affective Disorder (SAD), 60 – 90% of them are women. Light box therapy is an effective treatment for SAD. It’s always brighter outside, by the way, even on an overcast day, so get outside and get some light!

The amount of light we get during the day is one piece of the puzzle, however, the amount of dark we get at night may be even a bigger piece. Consider discarding the night light or substituting the bulb with a low blue light one. Wearing a sleep mask helps.

Dr. Jim Phelps in Corvalis, Oregon, in his study on Dark Therapy for treatment of bipolar disorder, recommends dimming the lights in the home starting around 9PM, or at least an hour before you go to bed. Television and computer screens emit a lot of blue light, the kind that wakes you up, so either don’t use those devices before bed or get yourself (industrial strength) blue-blocking glasses. He even cautions us to not use the vanity light when we brush our teeth just before retiring.

Another technique to help us sleep better is known as sleep hygiene. Some of the basic tenants of sleep hygiene are as follows:

• Fix a bedtime and a wake up time

• Reserve the bedroom only for sleep, in other words, remove the TV, computer, craft table, etc…

• Develop a sleep ritual, such as, take a bath, have a light snack, read for 15 minutes, etc…

• A good bedtime snack are bananas, which are a good source of tryptophan

• Avoid caffeine within 4 to 6 hours of bedtime

• Avoid sugary or spicy foods before bedtime

• Avoid strenuous exercise just before bedtime

• Be sure you have comfortable bedding

• Try to eliminate noise and light in the bedroom

Meditation

A new meta study of meditation conducted by a team of researchers at John’s Hopkins Medical Center, lead by Madhav Goval, MD, indicates that meditation is as effective as antidepressants, but with no side effects.

Mindfulness meditation, also know as Vipassana, was shown to decrease depression by improving “attention regulation, body awareness, emotional regulation, and changes in self-perspective (e.g., de-centering).” Mindfulness meditation was seen to reduce activity in the amygdala, the area of the brain governing the stress response as well as reduced activity in the default mode network (DMN), a network of brain areas that support self-referential processing, and is active when our mind wanders, which turns out to be about 50% of the time. Mind wandering is linked to unhappiness. Meditation has also been shown to be effective in pain reduction.

Similar results were found in another meta study, published in the Journal of Alternative and Complimentary Medicine, on the benefits of Transcendental Meditation (TM). TM was found to be more effective than psychotherapy in treating anxiety. In fact, participants in the various studies saw a reduction in anxiety by nearly 50%. This decrease in anxiety was achieved after only two weeks of meditating and was sustained for up to three years! Additionally, practicing TM was found to lower blood pressure, improve sleep, improve family life, reduce substance abuse and lead to better employment situations.

Nutrition

Certainly, there is a connection between our mental health and our physical health, and what we eat, or don’t eat, can affect our mood. For example, eating a lot of sugar can cause a high feeling and a subsequent crash. For those of you who have children, you know what I’m talking about! The effect is the same for adults if not less apparent. The same holds true for caffeine and alcohol. The crash, in all three cases, usually leaves you in a lower mood than you were in before you ingested the sugar, caffeine or alcohol. Therefore, think about moderating your intake of sugar, caffeine and alcohol. Consider limiting processed carbohydrates as well.

Certain foods have allergens, such as glutens, sea foods, chocolate and nuts, as just a few examples, and they can have drastic effects on our physical well being. You probably already know if you are have these or other food allergies, but if you are unsure, get an allergy test from your primary care physician. Your low mood could be due to in part to a reaction to foods or other environmental allergens.

The health of our gut generally, as well as all of our internal organs, can have a direct effect on our mood via the vagus nerve. The vagus nerve connects directly all of our internal organs to the brain. The nausea we feel when frightened, for example, is due to the communication of fear via the vagus nerve to our brain. “Gut instincts” are a real thing. In short, gut health is important: If our gut is happy, than we are more likely to be happy. Fiber from foods and probiotic rich foods or supplements can improve gut health.

Supplements

There are some dietary supplements that are known to improve mood. You may wish to consult your primary care physician if you are unsure about whether or not you can take any of these supplements, listed below, safely. A multivitamin is the place to start. A good multivitamin should have 25-50mgs of vitamin B1, B2, B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine);100mcg of folic acid, and 10mcg of B12.

Eicosapentaenoic acid and docosahexaenoic acid, EPA and DHA respectively, are omega-3 fatty acids that are known to improve mood as well as promote heart and joint health. Fish or krill oil supplements are the best source of omega 3 fatty acids. Aim for taking 500mg to 1000mg daily as well as eating fish three times a week. Fish with high concentrations of omega 3’s are mackerel, herring/kipper, sardines, fresh tuna, anchovy, salmon or trout. An alternative to fish oils are flax or pumpkin seed oils.

Vitamin D is very helpful in boosting mood. We get vitamin D from the sun, which is in scare supply in the northeast. Try up to 1000iu of vitamin D, although you may need more. Your doctor can order a blood test to better determine the amount of vitamin D supplementation you need. 

Magnesium, 600mg-800mg a day, preferably magnesium glycinate because it is highly bioavailable, is another supplement to consider. Chromium can be effective for atypical depression, which is characterized by weight gain/increased appetite, hypersomnia (sleeping a lot), heaviness in the arms or legs, or hypersensitivity to social rejection. 200mcg to 600mcg of chromium may help relieve these symptoms.

The amino acid 5-HTP can boost serotonin levels in the brain. Serotonin is a key neurotransmitter involved in depression. If you take an SSRI or other antidepressant, be sure to consult with your doctor or psychiatrist before taking 5-HTP. Lastly, theanine, found in green tea, can boost levels of GABA, gamma-aminobutyric acid, triggering neurotransmitter in the brain that promote calm, relaxation and reduce anxiety.

In Summary 

The four easy fixes for improved mental health, no matter how healthy mentally/emotionally you already are, deliver lots of benefits for minimal costs. Perhaps you could try incorporating in your daily life just one or two “fixes” at a time, see if they work for you, then try the others. What have you got to lose? Depression? Anxiety? Stress?

The costs are minimal.

• Exercise 30 minutes, three times a week

• Meditate 22 minutes a day

• Reduce your intake of sugar, caffeine, and alcohol

• Sleep at least seven hours a night

• Take a multivitamin, an omega 3 supplement, and a vitamin D supplement daily

However, the benefits are tremendous.

• Improved brain, heart and joint health

• Improves mood stability

• Reduced depression, anxiety, mania, stress and pain

References:

Archer, Dale M.D., Transcendental Meditation: A Treatment for Anxiety, Reading Between the (Head) Lines. (October 23, 2013), found at, http://www.psychologytoday.com/blog/reading-between-the-headlines/201310/transcendental-meditation-treatment-anxiety

Brach, Tara Ph.D. How to Meditate: A Guide to Formal Sitting Practice. Found at http://tarabrach.com/howtomeditate.html

Bergland, Christopher, How Does the Vagus Nerve Convey Gut Instincts to the Brain? The Athlete’s Way, (May 23, 2014), Found at, http://www.psychologytoday.com/blog/the-athletes-way/201405/how-does-the-vagus-nerve-convey-gut-instincts-the-brain

Brewer, Judson A., et al. Meditation experience is associated with differences in default mode network activity and connectivity. (October 4, 2011). Found at: http://www.pnas.org/content/108/50/20254.long

Cann, Kevin. Nutrition and Depression. Found at, http://robbwolf.com/2012/03/23/nutrition-depression. (March 23, 2012)  

Children and Sleep. National Sleep Foundation. Found at http://sleepfoundation.org/sleep-topics/children-and-sleep

Meditation for Anxiety and Depression? Found at http://www.hopkinsmedicine.org/news/media/releases/meditation_for_anxiety_and_depression

Phelps, MD, Jim. Bipolar Disorder, Light, and Darkness:
Treatment Implications. Found at

http://www.psycheducation.org/depression/LightDark.htm#brain. (original, July 2006; revised 1/2011; minor update 8/2013)

Top 5 natural anti anxiety and depression supplements, Better Health News, Vol. 4, number 2, found at http://www.thebetterhealthstore.com/newsletter/012910_top-5-anti-depression_04.html