As a practicing psychiatrist, I am no stranger to treating mental illnesses such as major depressive disorder, generalized anxietyor PTSD. But the last two years, like the coronavirus The pandemic changed the way we live, work and navigate the world; It has allowed me to understand both personally and professionally the importance of self-care for mental health.
That’s why I wrote a book about it called The Self-Healing Mind: An Essential Five-Step Practice for Overcoming Anxiety and Depression and revitalizing your life.
Let’s face it, most of us have a basic appreciation of the importance of eating a well-balanced diet, going to bed at a reasonable hour, exercising when we can, and how to afford attention ourselves can make us feel better. However, the idea that self-care can treat diagnosable mental illness remains a foreign concept to many people.
Whenever I meet a patient for the first time, I always ask about personal care. Questions like: How is your typical breakfast, lunch and dinner? How often do you move your body? Do you ever meditate?
I find that among patients who struggle more with depression, anxiety, or even exhaustion, personal care is often the last thing on their minds. I get it: a colleague once said to me, “How do you expect a patient to eat kale salad if he’s too depressed to get out of bed?”
Because of this, personal care (especially in recent years) has developed a bad reputation. Sometimes it can even feel like personal care is under siege. All the time, I come across chatter on social media suggesting that taking care of yourself isn’t what you need. It’s more time, a better job, a good therapist, or the right medication.
While there’s no denying that all aspects of our lives (including the chemistry in our brains and whether or not we can afford a nanny to help with the kids) can sometimes get in the way of us living optimally, ruling out the personal care and its benefits for mental health is not based on evidence. That means sweeping personal care under the rug can ultimately cause more harm than good.
With this in mind, I would like to highlight a recent Slovak study that looked at the role of self-care in improving depression during the coronavirus pandemic. The results were not easy, and that is exactly why I liked it. Self-care, like love, is complicated.
In the study, the researchers looked at more than 800 participants. They included assessments of self-care strategies that included health awareness, nutritionphysical activity, sleep quality and interpersonal and intrapersonal relationships.
While higher health awareness during the pandemic was associated with slightly higher depression scores, that’s understandable considering the emotional toll it’s taken on us learning to live and interact safely during the pandemic, other strategies like increasing the frequency of exercise and focusing on sleep quality were actually preventative for the development of depression.
Interpersonal and intrapersonal nutrition and connection were even less straightforward in this particular study, yielding conflicting results that depended largely on the age of the participant and the severity of their depression.
“Healthy nutrition” is a loaded term (and I think most nutritional psychiatrists would agree). However, aside from this study, the evidence is pretty clear that depression (and other mental illnesses) have at least some correlation with inflammation, and incorporating more anti-inflammatory foods into your diet (think Mediterranean) actually can improve mood. For more information on this, see the SMILES judgment.
In a post-COVID world, we are also connecting in different ways.
Before the pandemic, many of us spent more time with people in in-person meetings.
Now, after a day of seeing patients on Zoom, the last thing I want to do is spend any more time on Zoom. So I suspect we are still adapting to find better ways to connect in what is becoming a new state of normal. I’d love to see researchers explore the connection question again in a few years.
Essential reading on depression
So back to my colleague’s question, “How do you expect patients to eat kale salad if they’re too depressed to get out of bed?”
Start by appreciating that kale salad alone probably won’t fix depression. A holistic approach is needed, and as the study suggests, self-care has a role in improving mental illness, even if it’s not always straightforward.
That’s something I think we can all agree on.
