A doctor's favorite lifestyle tools for better mental health
By Austin Perlmutter, MD
Depression, anxiety, and other stress-related mental health conditions have rapidly become the norm in a world where mental health is so often an afterthought. In the US, the NIH reported that 8.3% of adults had depression in the last year, a number that increased to 10.3% in women. Other data suggest rates of depressed mood have climbed especially in young girls. And while conventional medical therapy can be a lifesaver for those with severe mental health issues, there’s lots we can all do to support better mental health through lifestyle. Here are 4 science-backed strategies to help boost mood.
1. Prioritize movement each day
For years, doctors like me have been recommending exercise to help prevent cardiovascular disease and to aid in weight loss. We’re now learning that arguably the most important effect of physical activity is the brain benefits. Regular exercise is one of the most potent ways of preventing Alzheimer’s and other dementias. But more germane to the topic at hand, exercise may help to prevent depression and treat it. Exercise may lead to these benefits through a host of pathways ranging from enhanced metabolic health to decreased inflammation to production of brain-boosting molecules like brain-derived neurotrophic factor (BDNF). This is life-altering news that everyone should know. Importantly, benefits are seen from everything from walking to yoga and lifting weights. The key is simply to get the body moving consistently. A quick list of activities that can help you get moving:
Take Short Walking Breaks: If you're working at a desk, take five to ten minutes every hour to walk around. This could be around your office, home, or even outside if possible.
Use a Standing Desk: Switch between sitting and standing throughout the day if you have access to an adjustable desk. If you want to take it to the next level, an under-desk treadmill can be a great addition.
Take the Stairs: Instead of the elevator or escalator, use the stairs. It’s a great way to build strength and endurance.
Park Further Away: When driving to places like the grocery store or office, park further away to increase your walking distance.
Incorporate Exercise into Leisure Time: When watching TV or listening to podcasts, use that time to do light exercises like yoga, pilates, or simple body weight exercises.
Walking Meetings: If possible, conduct meetings while walking. This is especially feasible for one-on-one meetings and is a great way to discuss ideas while moving. In fact, research suggests we may have better ideas when walking!
Set a Movement Reminder: Use a watch or phone app to remind you to stand up and move around or do a quick set of exercises like squats or jumping jacks every hour.
2. Eat a whole food diet (like the Mediterranean diet)
There’s so much debate over the “best” diet for the heart, for weight loss, and for the brain. But if you skip the tabloids, the science is clear. A diet like the Mediterranean pattern diet is likely most optimal for most people for most health-related outcomes. As it relates to depression, study after study has shown that eating a Mediterranean diet can help prevent depression, while other research suggests a potential benefit in those who already have a diagnosis. One reason for these findings may be the high levels of plant nutrients called polyphenols that are common in this dietary pattern. Along with other elements of this diet, polyphenols may help stabilize blood sugar, enhance immune health, and promote healthier blood flow, all of which may benefit the brain and subsequently mood.
The bottom line here is that choosing a diet rich in minimally-processed fruits, vegetables, nuts, seeds, olive oil, spices and herbs, with seafood prioritized over other forms of meat, (along with mindful eating in community when possible) is a vote for better mood. Here are a few examples of Mediterranean-style meals.
3. Get better quality sleep
Few things have such an outsized impact on brain health as quality sleep. But with so many people struggling with sleep issues, “get better sleep” isn’t always a helpful advocacy. In the context of mood, it’s been shown that poor quality sleep predicts a dramatically higher risk for depression. The big question is then: how do we get better sleep?
When it comes to enhanced sleep quality, there are several steps each of us can take. Step one should be to work on the “low-hanging fruit,” which should include cutting out afternoon caffeine, not drinking alcohol before bed, cutting off blue light and activating media consumption in the hours before bed and sticking to a regular bedtime and wake up time. Additionally, consider lowering the temperature in your room and keeping it dark and quiet. For many people, especially those struggling despite making these changes, speaking to your doctor or other health practitioner about a sleep evaluation can be a game-changing opportunity.
For those looking for some concrete steps to incorporate into today’s routine for better sleep:
Pause caffeine consumption after 12 noon
Skip the late-night alcoholic drinks and nightcaps
Lower your bedroom temperature to 66-68 degrees F
Keep your phone outside the bedroom at night (charge it in another room if possible)
Minimize use of bright lights in the hours before bed
Minimize screen time 1-2 hours before bed
Don’t over-hydrate before bed (getting up to go to the bathroom can disrupt sleep)
Skip the stressful conversations before bed
If none of this helps, consider reaching out to your healthcare provider about a sleep study
4. Bring mindfulness into your day
Let’s face it: with the advent of our 24-hour news cycle, social media, phone games and other entertainment options, it’s getting easy to spend our days mindlessly consuming content. The consequence of this perpetual exposure may very well be worse mental health. Luckily there are steps all of us can take to mitigate the negative effects of mindlessness on our mood.
In a 2019 meta-analysis, researchers looked at 25 trials specific to mindfulness in university students. They found that interventions built around enhanced mindfulness were successful in helping to prevent depression, with interventions on average taking about 7 weeks. Mindfulness practices used in the studies included paying attention to breath, reflective listening, going for mindful walks and others. The key takeaway here is that engaging in a regular practice that allows for reflection and pause from the hectic and perpetual content stream of the modern world can create lasting benefits to mental health.
Some popular mindfulness practices to try:
Mindful breathing (focus on inhalation and exhalation)
Mindful eating (avoid devices, just pay attention to the food)
Mindful walks (leave your devices at home, enjoy the scenery and how you feel)
Meditation (lots of types to try!)
Closing thoughts:
As mental health issues continue to spread and create lasting issues in people’s lives, we absolutely need to shift our conversation from focus only on treatment to a focus on prevention. Our society does an amazing job downplaying the role of long-term benefit in favor of short-term fixes. Unfortunately, this is contributing significantly to our epidemic of poor mental health. Getting ahead of the issue necessitates a more open dialogue about why so many people are experiencing mental health issues and then prioritizing effective preventive measures. The great news is that many of the best studied preventive strategies for depression are widely available, and directly mirror the preventive strategies already established for such conditions as cardiovascular disease and dementia. Choosing to engage in one or more of these science-backed tactics each day is an excellent way to vote for better mental health.
Note: The information presented above is not a substitute for seeking professional medical guidance for mental health conditions. If you or someone you love is struggling significantly with poor mental health, you should get help from a qualified mental health provider.