Mental Health in Tough Times – Part II

The following is Part II of Mental Health in Tough Times, contributed by Peter Farmer, who holds advanced degrees in research biology and history, and is also an RN and EMT.  Please see Part II for the Introduction and Items 1-6.

Today’s list includes 19 more tips on maintaining optimum mental health in tough times, both now and at the end-of-the-world-as-we-know-it.  Thanks, Pete.

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7.  If you have trouble tracking down the source of your mental illness, consider seeing an allergist. Simple, low cost skin tests are available to determine antigenic sensitivity to common environmental toxins and allergens, such as dust mites, mold, and fungi and so on. If you come up positive, remediation and abatement in your home, workplace, and elsewhere can be undertaken as needed.

8.  Lessen your toxic burden to cool systemic inflammation. Drink plenty of water or green tea, exercise until you are perspiring profusely, and use a sauna or steam bath if possible. Some authorities recommend periodic fasting to allow the liver to recover. Milk Thistle is commonly used in Europe as a dietary supplement to assist the liver in detoxification.  Targeted dietary supplementation may be called for under a physician’s supervision.  Note: Toxic levels of heavy metals (lead, mercury, cadmium, etc.) and other metabolic poisons are medical emergencies; if you suspect that you have been affected, do not attempt to treat the problem yourself. Seek professional medical attention immediately.

9.  Exercise has been shown to be as effective as or even more effective than psychoactive medication in lessening the symptoms and effects of mild-to-moderate mental illness, and in promoting emotional and cognitive well-being.  Human beings are designed to move – so get off the couch and do something active.  Neurochemical mapping studies and PET scans have shown that exercise has the ability to remodel the type and distribution of neurotransmitter receptor sites for such mood-critical compounds as serotonin, dopamine, epinephrine, and norepinephrine, among others.  All exercise is beneficial, but be sure to cross-train if possible, so you get the benefits of different types of activity, i.e., aerobic versus anaerobic, intense versus moderate, weight-bearing versus non-weight-bearing, and so on.

10.  Get your sleep – for most people, 7-8 hours of uninterrupted sleep is optimal. If you have sleep problems, get them addressed; high-quality sleep is critical to optimal health and mental/physical resiliency.

11.  Spend some time outdoors every day, if at all possible – running, walking, gardening, doing whatever you like. Important source of vitamin D, and gets you out into the fresh air.

12.  Practice deep breathing exercises.  Yoga practitioners and martial artists have long known the power of deep breathing to calm anxiety and lessen stress.  Sustained aerobic exercise has many of the same benefits. Biofeedback relies upon deep breathing, in part, to allow conscious control of heart rate, blood pressure, etc.  Studies of soldiers, police officers, and others subject to extreme stress have shown that control of breathing is an effective tool in lessening the effects of sympathetic nervous system “acute stress syndrome.” Controlled breathing is also extremely effective for managing lower but still debilitating levels of stress and anxiety

13.  If you are prone to anxiety for unknown reasons, you may suffer from a magnesium deficiency.  Ask your primary care provider whether a test of plasma Mg 2+ is called for.

14.  Cognitive behavioral therapy, as pioneered by David Burns, M.D., and others, is very effective at alleviating some forms of depression and other mental illness.  CBT relies upon the breakthrough discovery that how you feel and how you think are not independent of one another; one’s emotional state is directly and profoundly affected by patterns of thought and “self-talk.”

15.  If you are unhappy with where you are, keep moving. Action precedes motivation, not the reverse. These simply stated guidelines are critical especially for those in difficult or dire circumstances.  The historical and scientific record is quite clear; people do better under difficult or even life-threatening circumstances if they are doing something and not simply passively waiting for help or whatever fate has in store.  All other things being equal, resilient people have better survivability than people who are not – and a critical component of resiliency is taking action, even after setbacks. Or, as the old saying goes, “It isn’t how many times you get knocked down that counts, it is the number of times you get up.”

16.  Cultivate a positive, can-do outlook – even when things look tough.  Whatever your problem, you may fail if you try – but you will most certainly fail if you do not try to improve your circumstances.  And history is full of stories of people who overcame “impossible” odds to solve problems, survive in unbelievably hostile or unfavorable circumstances, and so on. A “can do” outlook is an important part of resiliency.

17.  Get help when you need it, and don’t be afraid to ask for it. Men especially, but many women also, hesitate to ask for help with mental health concerns, fearing that others will think less of them, and that they will be stigmatized as somehow less than others, unfit, unreliable, etc. The truth of the matter is that almost everyone has tough times at some point in their life, and can use a hand.

18.  Know the limits of at-home care. Some mental health problems cannot be solved alone, or only with difficulty. Still others, i.e., bipolar disorder, schizophrenia, etc., require sophisticated medical treatment and are largely unresponsive to “do-it-yourself” care.

19.  Have an annual physical exam, of which a mental health status check is a part. Your primary care physician is an important resource and gatekeeper to mental health specialists, such as psychiatrists, neurologists, etc.  Most general practice physicians have a well-established network to which they can refer patients as needed.

20.  Don’t neglect your spirituality or faith. If you are religious, worship in the manner that you choose.  Practice gratitude; authentic happiness isn’t possible without it.

21.  Lose yourself in your hobby. If you are musical, play or sing when you need to “escape the world;” or simply listen to whatever music soothes you.  If sewing makes you relax and improves your mental being, do that. If nothing makes you happier than tinkering with engines, do that – and so on.

22.  Keep company with other people or a beloved pet. Numerous findings have shown the link between   health, happiness, and being around people you care about.  Unmarried men, for example, tend to die younger than happily-married ones.  Pain, the so-called “fifth vital sign,” according to some healthcare practitioners, is lessened in chronic pain patients when they spend time with a treasured pet or a child.

23.  Help someone else, or simply visit an old friend or perhaps an elderly person in need of company.  Write a letter or call someone with whom you haven’t spoken in a while.  We lessen and are distracted from our own cares, worries, and suffering when we devote time and attention to those of others.

24.  Be curious about the world around you. Read a book in a subject that interests you, write a letter or solve a crossword puzzle, or take on a “do-it-yourself” project that requires concentration. Consider learning a language. Turn off the TV and do something that requires active engagement. Consider it a workout for your brain.  Doing this lessens your chances of suffering mental illness, alleviates symptoms of preexisting disorders, and lessens the odds of memory loss, old-age dementia, and other negative outcomes.

25.  Whatever your circumstances, do your best to be happy, or at least act that way. Angry, embittered and negative people not only suffer terribly from their state of mind, they inflict that suffering on others around them. Especially in a crisis, resilient people have the ability to bounce back, to adapt to whatever circumstances they are facing.  None of us can control how reality unfolds, but each of us can control how we react to it. Sometimes, that isn’t much – but this simple fact made the difference between life and death for some WWII-era Allied prisoners in enemy POW and concentration camps.

This concludes our round-up of mental health in tough times.  Your comments, questions, and suggestions are welcome.

Reference:  “The Ultramind Solution: Fix Your Broken Brain by Healing Your Body First” by Mark Hyman, M.D. Scribner, NY City, 2009.

Copyright © 2011 Peter Farmer

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About Cynthia J. Koelker, MD

CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
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