World Mental Health Day

If you have been browsing social media today (and let’s be honest if you have found this post you probably have been), you will most likely have seen it is World Mental Health Day today, the theme mental health for all. Given my job as a psychiatrist, I feel I should post something about the day, but I have left it a little later than I might have liked.

The reason is primarily I have had a busy day (and week), and finding time to write has been challenging. At the same time, it also feels challenging to write something meaningful on this year’s theme at a time when so many people are struggling and mental health difficulties seem to be more prevalent than ever. I’m sure it’s not just me who feels every time we take a step forward, we are pushed a dozen steps back, and I know through my work, but also speaking with family and friends, people are starting to struggle.

I have decided then to focus this post, in keeping with the theme I hope, on ways to improve our mental health in the midst of COVID-19. I am not the first person to write about keeping well through a pandemic and lockdown (whatever that might mean for you at the moment). I myself have tweeted frequently about ideas to keep well in the face of anxiety and depression, but it cannot hurt to bring together once more a selection of self-help ideas you can certainly try at home.

And remember, if you are struggling, if you think things are getting too difficult or self-help is not working, and even if you are not sure what help you might need, please seek professional help. People are waiting to talk, to help. If you’re in the UK or Ireland, Samaritans among others are a good place to start, and for those of you reading from elsewhere in the world, this helpful Wikipedia article has a list of contact details which may be of help to you.

Diet and Exercise

There is not denying our mind and mental wellbeing are inextricably linked to our physical health (only the most ardent dualist would argue otherwise). Focussing on what we are putting into our bodies and getting regular exercise can be a good start to improving our wellbeing.

Focus on increasing the amount of fresh fruit and vegetables in your diet if nothing else, while trying to cut down on the quantity of processed food. If you are overweight, it is going to help to cut down a little as well. Losing weight is a constant challenge, I know that well, but it is worth it in the end I promise. You will be amazed what the addition of even just a few changes to your diet can make to your energy levels and how you feel.

It does not need to be complicated to add in more veg. If you are making a pasta dish for dinner, for example, could you chop up some peppers or carrots and add them in? How about going to the freezer and through in some garden peas? While fresh veg is better than frozen, frozen veg is a lot better than nothing at all. Getting fruit into the diet can be even easier, instead of the biscuit or cake with your drink, have an apple. Simple as that!

Exercise can be whatever you enjoy doing to raise the heart rate or stretch the muscles. If you love going for a run, cycling or lifting weights at the gym, then fantastic, consider what exercise you are already doing and if you can consider increasing it by say 10%.

If like me you find it a challenge to fit exercise into your day, then you might want to think of ways to can at least find yourself walking about more. Can you walk to the local shops instead of driving? If you are catching a bus, could you walk to the next bus stop instead of the one closest to you? If you are stuck in the office all day (or more likely the home office), then could you take time for a walk at lunch as well as when you get home or finish work? Fitting a little extra activity into your day does not need to be complicated, and if it is activity beyond what you would usual do, then all the better!

Get outside

Forest bathing (shinrinyoku) and nature based therapies have become an area of increased interest in the last year. At a time when we have had to spend increasing amounts of time at home, I have real valued being able to get out to green space, from parks and woodlands to just my back garden if that was all that was available. And the evidence increasingly supports immersion in nature as a boost to the mood and a way to lessen anxieties.

Finding yourself lost in a woodland for a couple of hours each day would be ideal, especially if you live in an urban environment like me. But it is unlikely to be a practical option for most people, so we need to utilise what space is around us. Is there a local park or green area you could wander in? Could this be the setting for your daily exercise? If you are fortunate enough to have a garden, get outside, enjoy the space and grow something (is it time to be planting those vegetables ready for next year?). Even those of you in flats or without a garden space can benefit from a herb box on the windowsill, or a few house plants scattered around the place.

If you are exercising in nature, remember to allow yourself to be fully immersed in the space. Take out the headphones, put away the phone, and enjoy the sounds and smells as well as the sights around you. For the full benefit of nature you need to see and smell and hear and touch and maybe even taste it (just keep away from those red berries…). Blocking out the world with headphones and smartphones will only detract from the benefits to your wellbeing.

Put away the phone

Continuing with a theme, make sure to give yourself time away from the phone and screens. More and more we are spending time sat at computers or tablets, working remotely and relying on technology to allow us to keep in touch with people. Video calling and social media have been invaluable tools I am sure for many people to keep in touch during the pandemic, but there comes a point each day when we just need to switch off.

Consider setting yourself an hour (at least) each day when the phone and other screens will be off. Put the phone out of arms reach and pick up a book, your knitting, a model aeroplane, spend time with the kids, whatever hobbies and interests you have which do not involved computers, social media or even TV. You can even do absolutely nothing but thinking if you want (see below for more details). And make sure to tell people of your screen free hour, make sure they give you the time without trying to get I touch, or expecting responses immediately. This is time just for you (or your immediate family). Do not be worried or ashamed of being selfish, sometimes a little me time can do you the world of good.

Do nothing, or be mindful

How often in the day do you spend time doing nothing (and sleeping does not count). I suspect the answer is not very for most of us. We lead busy lives, and trying to fit everything which needs doing into our day can be challenging. But making space to do nothing can gives us a boost to help us achieve those other things which are filling the day.

Consider setting aside even just twenty minutes in the day. Find a quiet room (or better still a quiet space outside in nature) and do nothing. Well, not exactly nothing. Of course you will be watching what is in front of you, listening to the sounds around you, smelling the scents passing you by. Focus on just what is happening in the here and now. Ignore what has happened in the past which might be worrying you. Forget for a moment about future events and plans which might cause you distress. If you find your mind wandering don’t chastise yourself, rather bring yourself back to the moment and focus again.

The keen eyed amongst you will notice what I have described in mindfulness, or at least my interpretation of it. I called it doing nothing as I know there is an eyerolling-resistance to mindfulness for some people, who see it as a fad. But it does work, and can work for you. Like everything else I have suggested here it is not something which will work as a one off event, it takes time and practice to be able to focus our minds in the moment, but with a little effort it becomes easier, and the evidence suggests it will help you reduce your anxieties and may even boost your mood to boot.

Sleep well

More and more sleep is becoming a focus of my day job. The increasing understanding of sleep and the important role it plays in our health and wellbeing cannot be overstated.

At the same time, medical options for improving sleep remain poor, and are certainly at the bottom of my listen of go to ideas to help someone who is struggling to sleep.

Instead, when I am supporting patients with poor sleep, I focus instead on good sleep hygiene to promote a restful night. While the ideas below might seem obvious, it is worth reinforcing as if these tips are followed regularly, there is a good chance you will see a more restful night’s sleep and feel a world of good the next day as well

  • Exercise during the day (see above) is an important first step to a good night’s sleep. Get moving regularly, and at night you will most likely sleep better
  • Cut out the caffeine, at least get rid of it after say 6pm. And remember it is not just tea and coffee which is full of the stuff, cola and chocolate for example are best avoided late in the day
  • Cut down on alcohol (something I have not touch upon elsewhere in this post, but a good idea for mood boosting as well). Alcohol might make you feel sleepy, but the sleep it gives you is often restless and disturbed.
  • Turn of the screens (again), especially in the last hour or so before bed. Blue-tinged screens are not good for promoting sleepiness.
  • Create your sleep space, ideally a room which is dark (I swear by my blackout blind), quiet and reasonably cool (though not so cold that you find yourself shivering all night). And make sure you are not using your sleep space for other things during the day. Beds are for sleeping and, well… you know…
  • Start a bedtime chill out routine. Turn of the TV, computer and put down the phone. Maybe chill out with a warm bath, or read a book. You might listen to music, providing it is calm and relaxing.
  • When you start to feel yourself drifting off, now is the time to head to bed. Keep things calm, turn off the lights and try to drift off to sleep.
  • If it works, great, but if it does not, don’t panic or get angry. Instead, get up again and start the routine again. Lying in bed worrying about not sleeping is not going to help matters, take yourself back to the sofa and begin to relax again.
  • Finally, regardless of the night’s sleep you have had, try waking at roughly the same time each day. Having a regular wake time can be a big part in promoting restful sleep the following night.

Stay in touch

Finally, and possible most importantly during periods of lockdown and uncertainty, make sure you stay in touch with people. It can be easy to isolate yourself off from the world when we are advised to stay at home, but losing touch with people is a sure way to see your mood dropping and anxieties building.

Whether it is on the phone or video call, at a social distance (if the rules allow) or even getting the pen and paper out and writing an old-fashioned letter (it might sound silly but it can be a very therapeutic way to relax and explore issues which might be worrying you with someone else in a controlled manner), make sure you are making time to be with others. In the rest of this post I have been advocating less screen time, not more, but for this reason only I am willing to concede smartphones and tablets have there uses. Set aside time during the week to stay in touch with family and friends, check in on each other not just for your wellbeing but potentially also for their’s, and make sure you know who you can turn to should things become more difficult.

This is a time when we have to spend more and more time apart, so it is more important than ever to find ways to stay in touch when we cannot always be in the same room.

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