What is the cure for anxiety, depression, or any other mental health disorder for that matter? When you're sick you go to the doctor, get a diagnosis, and possibly get a prescription. A mental health diagnosis is more complex though and often the relief from mental illness is a myriad of interventions. Throughout my own journey towards mental wellness as well as my journey as a therapist I have cultivated an idea that I have started calling the "Puzzle of Well-being". A puzzle is made up of many different pieces that make up a picture, you don't necessarily need every puzzle piece to be able to identify what that picture is and every puzzle is different, therefore it's pieces are different. Some puzzles have only 10 pieces, typically meant for younger children; they are simple and you can figure out the picture with a fraction of the pieces. Some puzzles, however, have 1,000 pieces. These puzzles are more complex, they take longer to complete, they can feel overwhelming to start, and you need more of the pieces to understand what the picture will be.
This is how I see mental health. There are common puzzles like anxiety, depression, PTSD, etc. but each individual requires something very different to alleviate symptoms of mental illness. Some examples of the most common "pieces" I encounter are therapy, meditation, medication, grounding techniques, relaxation techniques, self-care, reading, talking, singing, dancing, and the list goes on.
So where do we start? When I start a puzzle I typically start with the corner pieces. As a therapist, I see the corner pieces to wellness as sleep, nutrition, exercise, and social support. These are the areas that I assess right from the start and then in my head I find myself singing "you can't have one without the... other".
Let's start with sleep. Lacking sleep has turned into a massive badge of honor and bragging rights around the water cooler. I would love to see co-workers, friends, and family bragging to one another about the amazing rest they got the night before! Sleep has been studied countless times and more recently been studied to find a correlation between good sleep hygiene and mental illness. Study after study confirms and emphasizes this correlation. A Harvard study writes the following takeaway messages, "Sleep and mood are closely connected; poor or inadequate sleep can cause irritability and stress, while healthy sleep can enhance well-being" and "Chronic insomnia may increase the risk of developing a mood disorder, such as anxiety or depression." For those interested, this is another great study on sleep and how vital it is to our health and wellbeing.
Since this is not a post about sleep and the importance of good sleep hygiene, I'll leave this here, but for these reasons, I do consider sleep as one of the "corner pieces to well being".
Exercise and nutrition are the next corner pieces. When I say exercise, I don't mean you are hitting the gym for an hour each morning. I mean moving your body enough to get the blood flowing throughout the body and brain even a quick walk around the block to move your body through space and time. Realistic expectations are the name of the game when it comes to exercise.
Nutrition is up next and I feel like nutrition is a given. If we eat like garbage, we feel like garbage. A poor diet can lead to feelings of lethargy, fatigue, and even feelings of failure, therefore, making it challenging to exercise. A poor diet can also confuse our brains with artificial sugars leading to challenges with.... you guessed it.... sleep. As a side note here, please don't read that I'm saying you shouldn't have that ice cream as a treat! If you want it, eat it! Just perhaps serve it in a mug instead of a soup bowl and be absolutely sure to enjoy every delicious bite!
The fourth corner piece I have identified is social support. This piece looks different from one individual to the next. Social support can come from one person in your life or it could be a wide network of support that spans the globe. My point here is social support can alleviate symptoms of depression and anxiety by reducing the risk of isolation which has been proven to be detrimental to our bodies and our brains. The U.S. Centers for Disease Control and Prevention has also reported that:
Social isolation significantly increases a person’s risk of premature death from all causes.
Social isolation is associated with a 50% increased risk of dementia.
Poor social relationships are associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.
Loneliness is associated with higher rates of depression, anxiety, and suicide.
Loneliness among heart failure patients is associated with a nearly four times increased risk of death, a 68% increased risk of hospitalization, and a 57% increased risk of emergency department visits.
So this is a very brief explanation of what I have been thinking about and working through over the years. What does your puzzle of well-being look like? Could you perhaps add a few more pieces to it to see your picture of mental wellness a little clearer?
While on this journey, keep in mind that the one area that a puzzle is not like mental health, you can finish a puzzle.