Mental Health 101: How To Improve Your Mental Health Without Going to Therapy

We don't feel acute pain when we decide to skip our workout one day, nor when we roll down the car window in the drive-thru line to grab a sack of fast food. As a result, we dramatically underestimate the effect that lifestyle factors have on our subjective well-being (mood, stress level, energy) and our physical health. What's worse, when we begin to feel overloaded with work and stress, our instincts are all wrong. We believe we can get more done if we sleep a little less or forego exercise until we get our To Do list under control. Studies show that these shortcuts actually have the opposite effect: we get less done and we feel more stressed out.

If you want to feel happy, energetic, and under control, you must take care of yourself in the domains discussed below – sleep, exercise, and diet. Attention to these factors is not always sufficient to produce a positive outlook, but anyone who neglects them will eventually pay a price (stress, lethargy, and negative moods). Next time your life gets hectic, be aware of the temptation to go to bed late, skip workouts, and eat fast food, and do exactly the opposite!

Sleep

We take sleep for granted because we fail to recognize the connection between inadequate sleep and the many, serious difficulties that result from it. When we are sleep deprived, even a little, our cognitive performance and energy levels decrease. One study evaluated medical interns, newly-minted MDs who are frequently required to work long shifts. The interns made seven times more errors when they were sleep deprived relative to when they were well rested. The study did not assess trivial mistakes, so all those errors were significant medical errors.

Even if you are in a profession where an error is not likely to cost someone their life, the mental fog that comes with sleep deprivation has huge costs. When you haven't had a good night's sleep, you don't think as clearly, and you don't work as quickly. You lose productivity and, if you are self-employeed, you literally lose income. A prominent sleep researcher (Craig Heller, Stanford University) argues that the annual cost to American businesses in lost productivity, due to the sleep-deficiency of their employees, is literally greater than the U.S. government's annual deficit.

As most of us know from experience, not getting enough sleep also leaves us more vulnerable to stress, and prone to negative moods. Interestingly, when we are sleep deprived, our brains exhibit a memory bias that favors negative information. That is, when we are tired, we are more likely to encode (i.e., enter into memory/store) and contemplate negative information relative to neutral or positive information. Selectively focusing on the bad stuff in our lives contributes to negative moods and, over time, frank depression.

It's not just our emotions and work-productivity that are affected by insufficient sleep. Our bodies also suffer serious, direct effects. The immune system is compromised: sleep-deprived individuals are three times more likely to catch colds than those who are well-rested. Sleep deprived individuals are also more likely to contract other infectious diseases.

In addition, the endocrine system is affected, and that means your vanity could suffer serious harm. Have you ever noticed that you are hungrier on days that you did not sleep well the night before? Just one or two nights of poor sleep causes appetite-stimulating hormones (e.g., ghrelin) to increase and hunger-inhibiting hormones (e.g., leptin) to decrease. Thus, when you don't get a good night's sleep, you overeat. If you do it very often, you will gain weight. Furthermore, over longer periods, people who are sleep deprived tend to become insulin insensitive, and they are at greater risk of developing Type 2 diabetes.

In case you still lack sufficient motivation to get a good night's sleep, I have saved one of the most frightening facts for last: Our bodies appear to clear waste products from the brain much more efficiently when we are asleep, relative to when we are awake. Animal research suggests that this applies to beta-amyloid, the precursor of the amyloid plaques that develop in the brains of Alzheimer's patients.

Summarizing bluntly: If you do not get sufficient sleep, you will perform well below your actual ability at work; your mood will stink, and you will be more likely to get sick and fat.

How much sleep do you need? Research indicates that most adults need 8 hours of sleep each night.

Exercise

Our physical and mental health suffer enormously when we do not exercise regularly. It's not surprising that humans evolved to be healthiest and happiest when we have an active lifestyle. After all, until very recently in human history, we had to stalk and kill game -- or walk thousands of steps each day gathering plants -- if we wanted to eat.

Each of us needs 30 minutes of sustained aerobic exercise three times a week, and results are better if we make it 45 minutes. Research shows that this lifestyle change alone reduces symptoms of mild to moderate depression as much as psychotherapy or antidepressant medication! (Of course, aerobic exercise also reduces the risks of heart attacks and strokes, improves cognitive functioning, and decreases the probability that we will be diagnosed with Alzheimer's disease.)

If you are over 40, obese, or have health problems, check with your physician before you begin an exercise program. Start slowly (e.g., a 5 minute walk three times a week) and work your way up to a therapeutic level of exercise over several months.

Diet

Don't go hungry, but pay attention to what you eat. The evidence is clear: your diet affects your mood.

Diets that consist of multicolored vegetables and cold deep-sea fish (e.g., salmon) are associated with lower rates of depression and other emotional problems. Some evidence suggests that such pescovegetarian diets may also reduce the incidence of age-related cognitive decline as well as Alzheimer's and Parkinson's diseases. In contrast, diets that are high in animal fat and refined carbohydrates (e.g., sugar) increase inflammatory processes throughout the body and have deleterious effects on your health. Consuming excessive sugar and saturated fat contributes to many ailments including obesity, diabetes, and heart disease.

While many people underestimate the importance of diet, others make the opposite mistake, attributing magical properties to fad diets. Beware of any diet that claims to cure cancer, heart disease, depression, or any other malady. Scientific evidence clearly indicates that pescovegetarian diets are healthy, but there is no evidence to support the claims made by advocates of the numerous fad diets that appear every year. Also beware of supplements. The supplements industry is unregulated, and recent investigations have demonstrated that a large percentage of the supplements on store shelves actually do not contain the active ingredient that they claim is in the bottle. Moreover, some are dangerously contaminated -- including the expensive ones that claim to be "pure." To learn more about this, watch the January, 2016 episode of the PBS series Frontline: Supplements and Safety. Unless your physician recommends otherwise, get your vitamins and minerals from fresh foods.


Recommended for a General Audience

Heller, Craig. Secrets of Sleep Science. The Teaching Company, 2013.

Hertzog, C., Kramer, A. F., Wilson, R. S., & Lindenberger, U. (2009). Fit body, fit mind?. Scientific American Mind, 20(4), 24-31.

PBS. (2016). Frontline: Supplements and Safety.

Stickgold, Robert. (2015) Sleep on it. Scientific American, October, 2015.


References

Appleton, K. M., Rogers, P. J., & Ness, A. R. (2010). Updated systematic review and meta-analysis of the effects of omega− 3 long-chain polyunsaturated fatty acids on depressed mood. The American journal of clinical nutrition.

Barger, L. K., Ayas, N. T., Cade, B. E., Cronin, J. W., Rosner, B., Speizer, F. E., & Czeisler, C. A. (2006). Impact of extended-duration shifts on medical errors, adverse events, and attentional failures. PLoS Med, 3(12), e487.

Colcombe, S., & Kramer, A. F. (2003). Fitness effects on the cognitive function of older adults a meta-analytic study. Psychological science, 14(2), 125-130.

Deslandes, A., Moraes, H., Ferreira, C., Veiga, H., Silveira, H., Mouta, R., ... & Laks, J. (2009). Exercise and mental health: many reasons to move.Neuropsychobiology, 59(4), 191-198.

Erickson, K. I., & Kramer, A. F. (2009). Aerobic exercise effects on cognitive and neural plasticity in older adults. British journal of sports medicine, 43(1), 22-24.

Fernandez, F., Lu, D., Ha, P., Costacurta, P., Chavez, R., Heller, H. C., & Ruby, N. F. (2014). Dysrhythmia in the suprachiasmatic nucleus inhibits memory processing. Science, 346(6211), 854-857.

Fotuhi, M., Mohassel, P., & Yaffe, K. (2009). Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer disease: a complex association. Nature Clinical Practice Neurology, 5(3), 140-152.

Freeman, M. P., Hibbeln, J. R., Wisner, K. L., Davis, J. M., Mischoulon, D., Peet, M., ... & Stoll, A. L. (2006). Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. Journal of Clinical Psychiatry,67(12), 1954-1967.

Gerstner, J. R., Aton, S. J., & Heller, H. C. (2015). Waking up to the alarm: sleep, clocks, and making memory (s) tick. Frontiers in systems neuroscience, 9.

Gómez-Pinilla, F. (2008). Brain foods: the effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568-578.

Gu, Y., Nieves, J. W., Stern, Y., Luchsinger, J. A., & Scarmeas, N. (2010). Food combination and Alzheimer disease risk: a protective diet. Archives of neurology, 67(6), 699-706.

Hamer, M., & Chida, Y. (2009). Physical activity and risk of neurodegenerative disease: a systematic review of prospective evidence.Psychological medicine, 39(01), 3-11.

Heller, C. (2014). The Ups and Downs of Synapses during Sleep and Learning. Sleep, 37(7), 1157.

Heller, H. C., Ruby, N. F., Rolls, A., Makam, M., & Colas, D. (2014). Adaptive and Pathological Inhibition of Neuroplasticity Associated With Circadian Rhythms and Sleep. Behavioral neuroscience, 128(3), 273.

Kang, J. H., Ascherio, A., & Grodstein, F. (2005). Fruit and vegetable consumption and cognitive decline in aging women. Annals of neurology,57(5), 713-720.

Khaw, K. T., Wareham, N., Bingham, S., Welch, A., Luben, R., & Day, N. (2008). Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. Obstetrical and Gynecological Survey, 63(6), 376-377.

Kraguljac, N. V., Montori, V. M., Pavuluri, M., Chai, H. S., Wilson, B. S., & Unal, S. S. (2009). Efficacy of omega-3 fatty acids in mood disorders - a systematic review and metaanalysis. Psychopharmacology Bulletin,42(3), 39–54.

Lin, P. Y., & Su, K. P. (2007). A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids.Journal of Clinical Psychiatry, 68(7), 1056-1061.

Meerlo, P., Mistlberger, R. E., Jacobs, B. L., Heller, H. C., & McGinty, D. (2009). New neurons in the adult brain: the role of sleep and consequences of sleep loss. Sleep medicine reviews, 13(3), 187-194.

Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L., & Wilson, R. S. (2006). Associations of vegetable and fruit consumption with age-related cognitive change. Neurology, 67, 1370–1376.

Noaghiul, S., & Hibbeln, J. R. (2003). Cross-national comparisons of seafood consumption and rates of bipolar disorder. American Journal of Psychiatry, 160, 2222–2227.

Ornish, D., Lin, J., Daubenmier, J., Weidner, G., Epel, E., Kemp, C., ... & Blackburn, E. H. (2008). Increased telomerase activity and comprehensive lifestyle changes: a pilot study. The lancet oncology, 9(11), 1048-1057.

Raji, C. A., Ho, A. J., Parikshak, N. N., Becker, J. T., Lopez, O. L., Kuller, L. H., ... & Thompson, P. M. (2010). Brain structure and obesity. Human brain mapping, 31(3), 353-364.

Ruby, N. F., Fernandez, F., Garrett, A., Klima, J., Zhang, P., Sapolsky, R., & Heller, H. C. (2013). Spatial memory and long-term object recognition are impaired by circadian arrhythmia and restored by the GABA A antagonist pentylenetetrazole. PLoS One, 8 (8).

Sarris, J., Schoendorfer, N., & Kavanagh, D. J. (2009). Major depressive disorder and nutritional medicine: a review of monotherapies and adjuvant treatments. Nutrition reviews, 67(3), 125-131.

Sidhu, K. S., Vandana, P., & Balon, R. (2009). Exercise prescription: A practical, effective therapy for depression. Current Psychiatry, 8(6), 38.

Sui, X., Laditka, J. N., Church, T. S., Hardin, J. W., Chase, N., Davis, K., & Blair, S. N. (2009). Prospective study of cardiorespiratory fitness and depressive symptoms in women and men. Journal of psychiatric research,43(5), 546-552.

Therapeutic effects of exercise. (2000, September). Harvard Mental Health Letter, 17(3), 5–6.

Walsh, R. (2011). Lifestyle and mental health. American Psychologist, 66(7), 579.

Wolf, P. A., Beiser, A., Elias, M. F., Au, R., Vasan, R. S., & Seshadri, S. (2007). Relation of obesity to cognitive function: importance of central obesity and synergistic influence of concomitant hypertension. The Framingham Heart Study. Current Alzheimer Research, 4(2), 111-116.

© 2016 Glenn Hutchinson, Ph.D. All Rights Reserved.