Lifestyle Revolution in a Pandemic

These are unprecedented times around the world. The situation escalated much quicker than most people predicted. Now, many people in the United States are facing continued statewide stay at home order for all non-essential persons. If you are stuck at home you may be trying to find alternative ways to use your time. Maybe it’s time to clean the garage or work on the yard as the weather in most parts of the country starts to improve. One way I’ve observed many people using their time is walking, running, or doing home workouts to improve their health and wellbeing. Despite the situation we can use this time to focus on lifestyle changes that can continue long after the pandemic ends. 

I’ve always believed that lifestyle interventions specifically diet, exercise, sleep, and stress reduction is key to improving both mental health and physical health. I’ve been using lifestyle modification to help improve symptoms of depression and anxiety for the past year in my patients. I’ve been successful in reducing depression ratings on the Hamilton depression inventory (HAM-D), medication dosage, and reducing body weight in several patients with these interventions. There is also a growing body of literature on the topic of lifestyle modification and mental health. I’m going to provide some general tips for getting started with lifestyle modification. 

Before starting any diet or exercise program you should consult with your doctor. 

1. See a primary care provider (might be difficult under the current circumstances): Make an appointment with a primary care physician, and get baseline results including waist circumference, BMI, blood pressure, fasting blood glucose, fasting lipid panel, basic metabolic panel, thyroid stimulating hormone, and complete blood count. There are additional tests that could be relevant on a case by case basis, but these are the basic things we want to see to establish a baseline. At the very least you can get a weight and BMI calculation if you have a scale and a measuring tape at home. 
2. Nutrition: Schedule a consult with a registered dietician to help create a manageable diet. You can also research diets on your own, but I suggest you have a professional guide you in the process to ensure the information you are getting is accurate and not harmful. The best diets in my opinion are whole food plant-based diet or Mediterranean diet. However, it’s important to remember that dietary recommendations are individualized and should suit the needs and lifestyle of each person. At the very least you want to increase your consumption of fruits and vegetables while limiting the intake of red meat, sugar, processed foods, and alcohol. These are staples in the standard American diet (SAD) which almost everyone agrees is harmful to your health. 
3. Stress management: The modern life of most Americans is filled with more stress than any previous time in history. Finding ways to reduce stress, and recharge our mental batteries is essential to enhanced performance and overall well-being. The most prevalent method is mindfulness training and there is a verity of ways to incorporate this into a busy daily schedule. I personally prefer meditation applications like Headspace (free for the first few sessions then subscription fee) to help guide patients initially, but this is not essential and there are many free guided meditations available on YouTube free of charge. I will also provide a beginner’s guide to meditation in future posts. 
4. Exercise: The question of aerobic Vs strength training and which is better to incorporate in your daily life is a common one. I believe both forms of training have value and should be used on a daily basis if possible. Like many things it depends on the individual patients’ goals and needs. Strength training increases lean body mass, protects bone health, improves balance and flexibility among other things. Aerobic training helps with efficiency of respiration, improves blood flow to muscles, improves cardiovascular efficiency among other things.  I believe if your goal is improved general or mental health finding ways to use both types of exercise is essential.   
5. Sleep: Helping people sleep is a large part of a psychiatrist’s job. Sleep plays an essential role in mental health. Many people fail to get enough quality sleep and suffer excess day time sleepiness or poor work performance as a result. The first step from anyone who has trouble sleeping is to keep a sleep log for one month that we can analyze together. You can gain a lot of information from asking specific questions about sleeping patterns, but you still want to see the log because it brings the persons attention specifically to how they are sleeping. I also go over basic sleep hygiene which is a series 

I realize that some of these thigs will be difficult to do under the current circumstances. The key with anything in life is to just start. I cannot count how many times my life would have been improved if I made the decision to just start.