There is more wisdom in your body than in your deepest philosophy.
—Friedrich Nietzsche
A healthy body is the foundation for a healthy, happy mind and mood, or at least more manageable ones. Your strong body can help keep Sgt. Mind at bay, but he’ll definitely tell you to not bother with some of the physical self-care in this chapter. Chris often jokes with clients that their grandmothers were right—eating, sleeping, and getting exercise are the most important things you can do to take care of yourself. Taking care of your body is important to your physical health as well as your mental health, and your teen years are a good opportunity to get into lifelong habits of physical well-being.
In this chapter, we’ll explore the biological approach to managing depression from a number of angles, including sleep, exercise, diet, substance intake, and relaxation. We’ll again apply mindfulness and positive psychology to thinking about changes you can make in your life.
We get it—this is a hard one for young people these days. Between finding the time for studying and social life, both of which seem to take more time than in your parents’ day, getting a full night’s rest is no easy feat. Still, getting the right amount—for most teens, from eight to ten hours—can have a major impact on your mood, not to mention your brain and body’s overall functioning for everything you want to do, from athletics to academics to hanging with friends.
Just as important as getting enough sleep is getting regular sleep. For some who are depressed, sleeping too much might actually be part of the problem. This is part of what can be confusing about depression: some folks need to be reminded to go to sleep, some need to be reminded to get up. Getting quality sleep and getting consistent sleep are both important for your mood. So try to find a way to get to sleep and wake up around the same time most days, even if it means not sleeping in quite so much on the weekends. Your body needs the right kind of rest to fight off and keep depression at bay.
How much sleep are you getting on average?
Do you tend to have a similar sleep schedule most of the time?
Can you adjust anything in your schedule or ask someone to remind you to get a little more sleep? Or, if you’re oversleeping, can you set your alarm or have a friend text you to get up? Ask your parent to knock on your door? A number of things can keep your brain and body awake, so keep these points in mind for a good night’s sleep “diet”:
You may find yourself looking at this list and saying something Sgt. Mind-y to yourself like, Yeah, yeah—I know I should do this stuff, but it won’t help and I’ll never keep up with it anyway. Know that such thinking is completely normal. Very few people (even the two of us) do all these things every night.
You have all sorts of habits in your daily routine that you’ve built up over time. With a bit of deliberate effort, you can certainly make some changes to your nightly routine to get some good sleep habits going as well.
Distracting and depressing thoughts can be quite overwhelming, and often when we slow down, it seems like they speed up. It’s reasonable to be concerned that if we make some mental space, we might also be making room for Sgt. Mind to show up and start chattering at us. The temptation can then be to distract ourselves before sleep, to keep negative thoughts at bay. But of course the thoughts are only part of the problem. The bigger challenge is that we tend to believe our thoughts, when perhaps we’d be better off letting them go, rather than staying with them.
Try This:
Lie down, and allow yourself to get comfortable.
Imagine yourself sitting overlooking a beautiful river or stream, perhaps one flowing through a flowery meadow, the mountains, or maybe a deep, ancient forest. Take a breath, and allow everything to become more vivid: the colors, the sounds, even the smells of nature. As you sit and watch the stream flow by, you notice things floating along in the stream or on its surface. Leaves drift past, then disappear around the next bend.
You may start to notice that even in this beautiful place, thoughts, worries, and uncomfortable sensations are still present from time to time. Each time you become aware of one, imagine shrinking the thought down and placing it on a leaf floating past, and then watching it drift away. Some thoughts may get stuck, circling in an eddy or tangled up, but eventually they will float away. The key is to keep shrinking down the thoughts and letting them drift away. From time to time you may find yourself floating alongside the thoughts, getting farther downstream, but all you need to do is just notice where you’ve drifted and pull yourself back to shore, over and over. Just place your thoughts on the leaves and let them go, as many times as you need to.
If you don’t find leaves on a river helpful, there are other images that might work; for example, watching traffic going past on a highway or bridge from a distant height, or noticing clouds floating past in the sky, or watching fish swim by in an aquarium.
The research is clear—for many forms of depression, getting exercise is at least as helpful as medication. Other evidence shows that exercise not only boosts your mood but also gives you more energy and helps you focus and think more clearly and creatively, sleep better, and regulate your appetite. It doesn’t even take much; researchers now say that from ten to thirty minutes of moderately intense exercise a few times a week is often as good as more intense working out, at least for your mood.
Of course, mustering the energy to do anything (let alone exercising) is tough when depression is weighing you down. And we don’t want to make exercise another chore for you to stress about. But exercise doesn’t have to mean running around the track or joining a varsity sports team. There are plenty of ways to exercise that are just as beneficial to your mind and body as competitive sports. It just means moving your body. Even standing up while you read or do work can help.
Some forms of exercise have the added benefit of getting you outside, into the world of fresh air, sunlight, and color. There is increasing evidence that just being in nature can lift your mood and boost your psychological well-being, resilience, and even interpersonal skills. And getting some sunlight (within reason) is especially important if your depression tends to be worse in the winter, as it is for people with seasonal affective disorder.
You can likely find something that allows your body to move and your mind to let go of worries. Is there anything on this list more appealing than traditional sports? Use the blank lines to add your own ideas.
Getting (and staying) motivated for even the most fun, rewarding, or effective exercise is hardly easy. For that reason, what we suggest is to start small, especially if it’s been a while since you’ve exercised. Just walking for twenty minutes a day can boost your mood significantly. One young man Chris works with listens to stand-up comedy while he does his walk. Is there an interesting podcast, audiobook, or music you can listen to? If you make an exercise playlist of just five or six songs, you can easily get twenty or thirty minutes of even a mild workout. And one great way to get yourself to exercise is to do it with someone else. Meet a friend for a jog, or ask if friends, teachers, therapists, and other people want to take a walk instead of sitting around when you spend time with them.
List a few people you might be willing and able to exercise with, or even take a walk with, in the coming week:
Technology won’t make you exercise, but it can make exercise more appealing. Consider getting a fitness tracker device or app for your phone. Plenty of yoga, tai chi, Pilates, and other workout videos can be borrowed from the library, but just as many are online for free. There are also workout video games, including sports like tennis or bowling, or activities like dancing and aerobics.
Are there any exercise apps, videos, or video games that you’ve enjoyed in the past, or think you might enjoy? List them here:
Think about your schedule. Are there times you can fit in some formal exercise? A yoga or dance class, an intramural sport, a trip to the gym? Can you get someone to go with you? Pick an activity, and perhaps a person, and then put it into your calendar or phone. It may seem silly to schedule in your exercise, but for many people (including these two authors), if it’s not in the calendar, it will never get done!
Do you have appointments where you usually take the elevator when you could take the stairs? Are there times you can walk when you usually catch a ride? Write those down here, and put a reminder in your phone or calendar for the next opportunity you might have for “informal” exercise.
You may feel completely inactive, but chances are you’re at least walking some places, and that’s some exercise in itself. There may also be some ways to do more walking—to school, work, friends’ houses, or your appointments and activities.
While it won’t give you a high-calorie cardio burn, mindful walking will get you moving and reinforce your awareness of your body—both crucial to helping you shake depression loose. There are all kinds of ways to do mindful walking, but for this book we’ll share just a few with you.
Try This:
Mindful walking really just means being present and noticing all the sensations and aspects of walking. Once you get the hang of it, you can bring mindfulness to walking not just in your house but also in the world around you.
A positive-psychology variation on mindful walking is to bring deliberate attention to your surroundings, intentionally noticing what’s beautiful, interesting, or pleasing in the environment where you’re walking. This practice starts to shift our perception of the world, cleaning Sgt. Mind’s lenses of negative perception so that our minds break the habit of looking for the bad rather than the good in the world.
When our bodies are flexible and strong, our minds become more flexible and strong, happier, and less depressed and likely to fall for Sgt. Mind’s best lines. Yoga can be great for physical and mental flexibility, and it doesn’t have to mean putting on a special outfit or leaving the house. Just some comfortable loose clothes, even pajamas, are fine for these poses. You don’t even need a mat. If your floor is soft, great; if it’s hard, lay down a towel or two, or maybe a small rug.
Don’t push yourself too hard, and check with your doctor to make sure these poses are okay for your body. You can do these three poses in order, or you can just pick the ones that feel best to you. If you want some help visualizing these movements, there are about a million videos online you can watch.
This opening, empowering pose can quickly change the way you feel and bring up your energy level.
If that feels like enough, just rest there. If you want to keep going, you can sequence in the next pose, or do it separately.
This pose can feel really centering and powerful as you stretch your body out, balance yourself, and hold yourself up.
Again, if you feel good with that pose, just rest. If you want to keep going, move on to Upward-Facing Dog.
Like Cobra, this posture opens the chest and stretches out the back.
How did these postures feel physically and emotionally? Which felt most empowering?
If you had a favorite, which was it?
Which ones can you make time for in the next week?
Like sleep, our appetite usually goes in two directions when we are depressed: overeating for comfort, or undereating because we don’t have any appetite and nothing appeals to us. Healthy food is the best fuel for keeping depression in check and keeping your body and mind fit for remaining stronger and smarter than Sgt. Mind.
Food can be very comforting, but often the more comforting the food, the less healthy it is. That’s not to say that you have to be perfect about eating, but a few changes in diet can help your mood. It’s important to learn to distinguish between eating for sustenance and health (to feel better in the long run) and eating for emotional reasons (to feel better in the moment). The following chart can help you understand the differences.
As you review this chart, do you notice any of the healthy or emotional eating habits jumping out at you? We’ve all occasionally drowned our sorrows in a pint of ice cream or bag of chips, or have otherwise resorted to some emotional eating. That does not mean you have an eating disorder. It’s just that for some people, relying too heavily on food for coping with difficult emotions may be a sign of a more worrisome pattern.
Many teens, especially those with depression, have a complicated relationship to food and body image. Our culture sends mixed messages to everyone, and so you’re not alone if you’re confused about food and health. And some people feel guilty about eating even healthy foods or feel awkward eating in front of others no matter what they’re eating. These might or might not be signs of an eating disorder. It can be helpful to talk and reflect about what food and your body mean to you with trusted friends, family, or professionals.
Here are other suggestions related to nutrition:
What are your “emotional eating” triggers, if this is a problem for you?
For many teens with depression, overeating is not a problem, because they hardly have any appetite. You might fall into this category. Eating when you’re not hungry is a true challenge. Many young people skip breakfast or lunch, and yes, we’re going to sound like your parents when we tell you it’s important to eat three healthy meals a day!
If you can’t work up an appetite, try some foods that are easy to digest: trail mix, bananas, yogurt, toast, or dried fruit. These are pretty gentle on your system and give you the energy you need to think clearly. They also give you the energy needed to exercise and talk, and give your body the signals it needs to sleep properly—all of which can help you fight off the dark clouds of depression.
One young woman Chris worked with could not boost her appetite. She finally found it helpful to resign herself to the idea that eating food was like taking medicine: “I don’t like taking my pills, I don’t like eating my breakfast, and I don’t like getting exercise and talking to people, but they’re all medicine for my depression.” Maybe you’ve never been a breakfast eater; you don’t have to commit to eating breakfast forever, but try it for a few weeks the same way you would try medication.
Exercise can also help. Try scheduling exercise before mealtime to work up an appetite.
Right now, are you eating three balanced meals a day? What did you eat within the last twenty-four hours? And how does it stack up against the recommendations in this chapter? (Be honest with yourself!)
If there is nothing that seems appealing, what are some foods that are at least tolerable, even when you have no appetite or a nervous stomach?
What are some of your favorite healthy foods that you can eat in the next week? Can you get some healthy snacks, or ask your parents to pick some up for you?
Ideally we’d make our meals the anchor of awareness and bring mindfulness to all aspects of eating. It’s nearly impossible to do this with every meal, but try to set aside some time every week to either have a meal or snack in a mindful way. For your other meals, you could just eat the first few bites mindfully.
Try This:
Before you even take a bite, bring mindful awareness to preparing the meal. Notice details of how the food looks, the colors and textures, as you place it on the plate in an appealing way. Notice the sounds of preparation—the opening of cabinets and clinking of plates—and the smells of the food itself. Remain aware of the physical and emotional sensations in your mind and body, signals of hunger, and emotions that come along with preparing your food.
As you practice eating mindfully from time to time, you’ll better recognize your body’s signals for when it is hungry, what kind of food it really needs, and how much. You’ll eat because your body needs it, not because your depression wants an escape. Over time, your body and mind will become better able to maintain your mood when they get the nutrition they need.
Try eating a meal or part of a meal mindfully as described here. What did you notice about the experience?
So this is the part where we talk about cutting down on nonprescribed chemicals—alcohol, drugs, nicotine, and caffeine. Like everything else in this book, we aren’t judging the choices you make or suggesting you follow our advice forever. We just recommend that you make some changes to see for yourself if that affects your depression. And if you prefer not to write down your answers to the questions at the end of this section, you can think about them instead.
The fact is, drugs and alcohol might work in the short term to help you feel better, but the medium- and long-term effects on your body and mind only weaken your ability to keep Sgt. Mind quiet and depression away. If you’re hungover or otherwise recovering from substances, all your energy is going into that, leaving none to help you also recover from depression. Caffeine and nicotine might boost your energy when you’re feeling sluggish, but it can be easy to get dependent on them without realizing it. They also can raise your stress and anxiety level, which hardly helps anything.
Another risk arises if you’re also taking medication. Most antidepressants don’t work effectively when combined with drugs and alcohol, and many can have dangerous interactions. If you’re taking medication, check in with your prescriber about interactions.
What’s your substance intake like these days? Is it more than you’d like it to be, or more than your friends, family, or health care providers think is healthy for someone with depression?
What are the benefits of using these substances (for example, socializing with others, temporarily shutting off bad feelings)?
What might your use of these substances be costing you (for example, less money, more conflict with your family)?
Is there room to cut down? Are you willing to take a break altogether for a few weeks to see if it makes a difference in your overall mood?
If you take medication, like some people with depression, are you taking it as prescribed, regularly, and daily? If you forget often, what is one way you can remember (for example, by leaving a note on the bathroom mirror or setting an alarm)?
One of the most important ways to recover from any illness, including depression, is to relax. Stress basically makes everything worse, and that means both your physical health and your mental health. If you’re fighting both stress and depression, you’re starting with a major disadvantage. Finding some ways to reduce stress and relax more will free up energy to help you manage your depression. Of course, this is easier said than done. A 2014 study found that teenagers are more stressed out than any other age group in the United States, so you’re not alone.
Here’s some good news: Mindfulness and positive-psychology practices are some of the best and fastest ways to reduce stress. Healthy relaxation allows the body to recover and recharge with the energy it needs to fight depression.
What are some ways you like to relax? We all have different ones, so use the blank lines to add your own ideas.
Which of these can you fit into your schedule?
When we need more than just a relaxing activity, a formal relaxation practice can help.
Try This:
You can read along as you do this exercise, but you also might like taking turns with a friend, guiding each other. You can also record yourself (or someone else) reading the scripts aloud and then listen later.
Take a moment now and scan through your whole body, noticing how it feels at the end of this exercise. As you return to your day, you can return to some of this relaxation just by tensing and releasing a few muscles that are storing any tension.
Of course, you don’t always have twenty minutes to do a long mindful relaxation practice. There are a few short relaxation practices that might help, and their acronyms—CALM and HALT—make them easy to remember.
Try This:
When we lose track of our most basic needs, we often lose track of our moods as well. But we can check in with ourselves from time to time and see what our needs are, or what may be affecting our moods. Every so often, try to mindfully halt what you’re doing and ask yourself if you’re feeling any of the following:
Try This:
You might find that not taking care of your body’s needs leads to your mood dropping and your depression worsening. A few times a day, it can be helpful to check in with some parts of your body. This practice can give you early warnings about your mood.
What are some times you can use these short check-ins?
By now, you’ve hopefully learned some basic skills for mindfully taking care of your body in order to take care of your depression. We covered some of the basics of physical self-care, bringing mindfulness into sleep, eating, physical exercise, and de-stressing your body with relaxation.
What have you learned from this chapter about how depression gets you down in your mood so that you’re checking out of daily life?
What specific strategies or ideas from this chapter might help you lift your mood up and move you in toward people and activities?
What one strategy, idea, or tool are you willing to put to use in the next twenty-four hours? Write it here, and commit to doing so.