With every act of self-care your authentic self gets stronger, and the critical, fearful mind gets weaker. Every act of self-care is a powerful declaration: I am on my side.
Susan Weiss Berry,
American mindfulness coach, writer, and painter
The basics of taking good care of your body are well-known—eat well, exercise regularly, get enough sleep, don’t smoke, and manage stress. When it comes to calming emotional inflammation, all of these good-for-you measures still apply, but several interesting nuances come into play in terms of the specific elements that matter and why. Yes, you should still stick with a healthy, largely plant-based diet, do regular cardio and strength training workouts, get seven to nine hours of shut-eye per night, avoid smoking, and take time to decompress from stress. But that’s just the starting point. Especially during times of emotional inflammation, taking the extra steps to quiet your hyperreactivity, agitation, angst, or other uncomfortable emotions—from the inside out as well as the outside in—is more necessary than ever. When people are stressed to the nth degree, they often take the path of least resistance or let their healthy intentions slide, which certainly doesn’t help them feel better and may actually make them feel worse.
Let’s start with the issue of diet, a subject that’s often mired in confusion given the various claims that are associated with different eating plans. Food is such a loaded topic in its own right. People often have strong opinions about what’s good to eat and what’s not, when and where it’s acceptable to eat (or not), sometimes even attaching moral virtue to the way they eat. With a phenomenon that’s been dubbed “orthorexia,” people become so obsessed with eating healthy foods that they eliminate many ingredients, sometimes even entire food groups, and their rigid rules guide what they will or won’t do socially (for them, exercising with friends is okay, for instance, but going out for lunch isn’t). Environmental concerns often come into play as well, as some people make a concerted effort to buy local (to reduce their carbon footprint), go vegan (for compassionate reasons), or reduce food waste and packaging (for the sake of the planet). In other words, deciding what or how to eat can trigger a variety of emotions, some of which are difficult.
The truth is, food is still a basic human need, essential to our physical health, cognitive function, and emotional well-being. Just as loading up on junk food or sugary foods can send your blood sugar and mood on a roller-coaster ride, skipping meals or eating infrequently can leave you feeling depleted, physically and emotionally. While there isn’t a perfect diet for treating emotional inflammation, what does matter significantly is how your body responds to the foods you eat, and that depends in large measure on a rising star in the field of medicine: the gut microbiome. The gut microbiome consists of a community of more than one hundred trillion microorganisms, including bacteria, fungi, and viruses, that reside, albeit to varying degrees, throughout your gastrointestinal tract. There are ten times more microbes than there are cells in the human body! The idea of having so many “bugs” moving around in our intestines may feel off-putting at first, but the latest research suggests that the presence and function of these microorganisms are as critical to human health as, say, a properly beating heart.
Under optimal conditions the beneficial microbes far outnumber the harmful ones and coexist peacefully and symbiotically, playing key roles in the human body’s daily operations. The human gut microbiome is like a miniature factory, with an array of highly skilled workers delivering a volume and variety of products that boggle the mind. The hardworking microbes break down foods into small component parts that the body uses for various functions. They produce amino acids, the building blocks of protein, which are involved in nearly every process in the body. They help modulate the immune system, protecting the body against disease-causing microbes and other intruders. They produce vitamins needed for nerve function (B vitamins) and others that are critical to blood clotting (vitamin K). They are even involved in creating conditions in the brain that affect memory function, our ability to think and perform complex tasks, and even how we feel and behave. (That’s a lot of work for such tiny creatures!)
A burgeoning area of research shows that the gut microbiome is in constant communication with the brain. Like chatty teenagers, the gut and the brain send messages back and forth using the body’s neurons (via the enteric nervous system) and bloodstream (in the gut’s case). These messages influence your mood, your response to stress, your circadian rhythms, and even your sleep patterns. The gut microbiome, often dubbed the “second brain,” plays such a prominent role in conditions that affect our well-being that new research suggests the connection between the gut microbiome and the brain is at the forefront of a “new approach to mental health.” Indeed, the composition of the gut microbiome and the way your gut communicates with your brain may affect your risk of developing depression, anxiety, and other mood disorders. (Studies in Sweden and the Netherlands have identified what researchers say may be “melancholic microbes.”)
Here’s another shocker: It is estimated that 90 percent of serotonin, the well-known neurotransmitter involved in mood regulation, is manufactured in the digestive tract from . . . (drum roll, please) . . . the work of microbes! Gut bacteria have also been found to increase or decrease levels of other neurotransmitters including dopamine, which stimulates the reward, motivation, and attention centers in the brain; norepinephrine, which stimulates the “take action” functions in times of stress; and gamma-aminobutyric acid (GABA), which lowers anxiety and generally quiets the nervous system down.
Your microbiome, like your fingerprints, may be quite different from your friends’ and family members’ microbiomes. Each of us has a unique network of these microorganisms inside us. Initially the network is determined by genetic factors, then it is influenced by conditions at birth as we pass through the birth canal and drink our mother’s breast milk. As time goes on, where we reside and how we live—including the air we breathe, the water we drink, the foods we eat, and the chemicals we are exposed to, including the medications we take—can change our microbiome. This is where we can make choices, take charge of our health, and tip the bacteria balance in our microbiome in either a positive or a negative direction.
Let’s start with broad principles about eating patterns that can profoundly affect the microbiome. First, the sobering news: A high intake of starchy carbohydrates, simple sugars, saturated fats, animal protein, highly processed foods, and artificial sweeteners promotes the proliferation of bad actor microbes in the gut. Among many different harmful actions, these bad actors can promote inflammation and skew the ratio of health-promoting to health-threatening bacteria in the gut. Now, some good news: If you consume foods with the right types of bacteria and/or anti-inflammatory properties, you’ll help the good actors in your gut flourish and reduce inflammation throughout your body and mind.
In recent years, advances in nutrition research have identified specific components of foods that can improve the health of our guts. Probiotics, the beneficial bacteria or yeasts found in certain foods, and prebiotics, nondigestible components in certain foods, are high on the list—forming a dynamic duo for your gut. When you eat foods that are high in probiotics, they contribute to increasing the population of good bacteria in your gut. When you consume foods that are rich in prebiotics, these natural food components promote the growth of good gut bacteria (probiotics).
To make this less abstract and help you better understand their different roles, return to the image of your body as a factory that requires expertise and excellent teamwork to get the job done. Probiotics are the workers that help you thrive mentally and physically and deliver the product: optimal functioning of various bodily systems. They work night and day but need to be fed well to continue to function well. That’s where prebiotics come in. These highly nutritious foods keep the workers going. If you feed those workers a steady diet of fast foods or processed foods instead, their output drops and their chief product—your physical and emotional health—goes down with it.
Good sources of probiotics include yogurt, kefir, kimchi, sauerkraut, miso, tempeh, and kombucha—foods that naturally contain beneficial bacteria in the form of live cultures or that have developed good-for-you bacteria through the fermentation process. (Those who don’t consume dairy products can rest assured that many nondairy products, such as coconut-, cashew-, and soy-based milks and yogurts also contain these beneficial bacteria.) Prebiotics are plentiful in lentils, chickpeas, red kidney beans, garlic, onions (including shallots, spring onions, and leeks), asparagus, bananas, apples, chicory, Jerusalem artichokes, and savoy cabbage. Grains such as oats, bran, and barley are also solid sources of prebiotics. For a powerful impact, you can incorporate foods with probiotics and prebiotics in the same meal. Try sliced bananas in a cup of yogurt and sprinkle chia seeds on top or create a stir-fry with garlic, onions, asparagus, and tempeh.
Probiotics occur naturally in food and consuming them in their original form is preferable to taking them as supplements (meaning pills). This is mostly because the Food and Drug Administration does not require dietary or probiotic supplement manufacturers to prove safety, efficacy (whether or not the product does what it claims to), purity, or potency as it does for drugs, so you don’t always know what you’re getting with these products. Besides, there isn’t one type of probiotic that’s right for everyone. In a perfect world, you’d be able to undergo testing and get a probiotic prescription that’s personalized for you and your microbiome, and then you’d be able to consume the specific form of bacteria that would help you. Even in our imperfect world, a personalized prescription for your microbiomes may someday become routine—but we’re not there yet. In the meantime, the advice provided here falls into the won’t-hurt-could-help category for your physical and mental health, and since these food suggestions are inherently nutritious, there’s really nothing to lose by adding them to your diet.
Of course, the good gut diet also includes eating anti-inflammatory foods. To make it simple to choose the right foods, Andrew Weil, MD, a pioneer in the field of integrative medicine, created an Anti-Inflammatory Food Pyramid that’s loaded with nutritious vegetables and fruits, whole and cracked grains, beans and legumes (including lentils and peas), healthy fats found in nuts and extra virgin olive oil, fish and shellfish, whole soy foods, cooked Asian mushrooms, tea (white, green, and oolong), herbs and spices (such as garlic, ginger, oregano, cinnamon, and turmeric), and moderate amounts of red wine. (“Moderate” here means up to one glass per day for women, two per day for men.) When it comes to dietary fats, omega-3 fatty acids (found in flaxseeds, chia seeds, walnuts, and canola oil, as well as cold-water fatty fish like salmon, tuna, halibut, anchovies, and sardines) tend to have the most potent anti-inflammatory properties.
If your moods are all over the map, it’s wise to moderate your caffeine intake and alcohol consumption to avoid revving yourself up excessively or inadvertently depressing your mood. To keep your blood sugar (and hence your mood) on a relatively even keel, plan your meals and (healthy) snacks ahead of time so that you’re eating something every three to five hours. That way, you won’t get jittery or “hangry.” Also, include some protein in every meal and snack because protein takes longer to digest than carbs or fats do, so you’ll end up with a slower, more sustained rise in blood sugar, which will help keep your mood and energy steadier.
Ultimately, if you feed your gut bacteria well—with live and active cultures, fermented foods, plenty of fiber, and anti-inflammatory foods—and limit your intake of saturated fats, added sugars, and highly processed items, you can take charge of promoting a diversity of bacteria in your gut, which can in turn help you calm inflammation throughout your body and mind. Want some proof? A study at the College of William and Mary found that people (especially those with preexisting anxieties) who consume more fermented foods are less susceptible to social anxiety than others. Similarly, research has found that consuming yogurt or fermented milk—both available in nondairy options—on a daily basis can reduce people’s reactivity to stressful situations.
Don’t forget to drink plenty of water and other noncaffeinated fluids (caffeine has a diuretic effect) throughout the day, too. It may surprise you to hear that dehydration, even in a mild form, can affect your mood and mental function. Research shows that when healthy young women developed mild dehydration (on the order of losing 1.4 percent of their body weight) while exercising, it triggered a substantial downturn in mood. This included increased tension-anxiety, depression-dejection, and anger-hostility, as well as reduced concentration and a significant increase in fatigue or inertia. In healthy men who have been exercising, mild dehydration (from losing 1 percent of their body weight during a workout) brings on a similar response.
Here’s the hitch: Don’t count on thirst to warn you that you are becoming dehydrated; by the time you feel thirsty you may have already lost 1 to 2 percent of your body’s water content. Furthermore, some people are less sensitive to thirst and have little idea that they are dangerously dehydrated. Here’s some advice: Sip water frequently during the day. The current recommendations from the National Academy of Sciences suggest that women should consume approximately 91 ounces and men about 125 ounces of water per day from a combination of beverages and water-rich foods. If this sounds daunting, consider this: about 20 percent of your fluid intake comes from consuming water-rich foods.
To be clear: None of these dietary approaches provides an immediate or complete remedy for the angst, despair, agitation, or other ill-at-ease feelings you may be experiencing. There is no such remedy. But their cumulative impact over time can certainly help. Addressing these feelings effectively is a long-term proposition, an investment in gently calming the internal flames that can stoke your emotional inflammation over time. The goal is really to quiet the physiological turbulence inside you, which will raise the bar or threshold for what elicits your emotional reactivity.
These days, we are more sedentary in our personal lives and our work lives than our preindustrial brethren were. We’re living in an increasingly automated world. Instead of going shopping, we can order our clothing, books, groceries, furniture, and other household items online and have them delivered. We can have our dry cleaning picked up and delivered. We can do our banking from home and rely on direct deposit for our paychecks. We don’t even need to walk down the hall to communicate with a colleague; we can simply send an email or make a phone call. Sometimes we don’t even need to show up at work; we can telecommute, instead.
We, as a society, have eliminated many opportunities for movement from our everyday lives. And we are paying for it, because human beings were made to move and our brains have been set up to reward us for doing it. If we were meant to live like statues, we’d be fixed on pedestals, and we wouldn’t have arms and legs that can move in multiple directions. Regular exercise is critical not only for our physical health but for our mental health, too. It improves just about every aspect of our health, from head to toe, reducing blood pressure and heart rate, improving digestion, regulating blood sugars, and enhancing the quality of sleep.
A less apparent benefit of regular exercise is that it can improve your health and well-being by augmenting the number and diversity of beneficial microbial species in the gut. While no two people’s microbiomes will have the same response to regular exercise, most people will have an increase in microbes that reduce inflammation throughout the body, among other positive health effects. But—and this is a very big but, so pay attention here—when people stop exercising, the positive effects will disappear, and the microbiome will go back to the way it was before the exercise regimen began.
In addition to being energizing to your body and mind, exercise is also immensely effective in helping you manage emotions and sharpen mental functioning. Aerobic exercise, in particular, induces the release of brain-derived neurotrophic factor, or BDNF, a protein that occupies the receptor sites for cortisol so that the stress hormone can’t “land” and activate those sites. The result is that instead of getting a jolt of anxiety, you get a dose of brain nourishment. In other words, exercising, especially during stressful times, is like wearing a waterproof raincoat in a downpour: the moisture (stress) will sit on the surface but won’t penetrate and soak you with anxiety, fear, despair, and the like. This means that when stress causes an increase in cortisol levels, people who get plenty of exercise will deactivate the stress hormone more quickly than those who don’t. Aerobic exercise also raises the concentration of serotonin in the brain by increasing the transport of the amino acid tryptophan, a precursor to serotonin, across the blood-brain barrier.
In one study, researchers from Harvard University examined the effects of aerobic exercise (cycling, in this case) on people’s ability to regulate their emotions after a stressful task and concluded that regular exercise strengthens our emotional resilience to the prolonged effects of stress. In another study, researchers at the University of Mississippi had healthy adults engage in stretching, walking, or jogging for fifteen minutes, then showed them a film clip intended to elicit a negative emotional response. Those in the walking and jogging groups experienced lower levels of anxiousness and anger in response to the film, whereas those in the stretching group had higher anger scores afterward. Their negative emotions were triggered, in other words, simply because they didn’t get the emotional-regulation perks of aerobic exercise, as their peers did.
You may have had this experience yourself: after tying yourself into knots over a stressful issue, you go for a brisk walk or a jog and find that afterward, while the issue has hardly been forgotten, it no longer has the grip on you that it did earlier. Regular physical activity also reduces the impulse to ruminate about stressful events, which in turn can reduce your reactivity to stress and decrease your chances of experiencing a priming effect whereby your response to one stressor can influence, and often magnify, the way you respond to a subsequent stressor.
What’s more, in both men and women exercise can reduce depression and anxiety. In some cases, regular aerobic exercise works just as well as an antidepressant in treating major depression, and it may even be superior at reducing the risk of a recurrence of depressive symptoms. The factors are complex, the neurotransmitters are varied, and people are different. But if you net it out, it’s indisputable that exercise really is good therapy for mood management, which is why more and more mental health professionals are prescribing it.
So the million-dollar question is, What type of exercise is most effective at relieving emotional inflammation? The answer is that it depends on you—the forms of emotional inflammation you have, how your brain is wired and your body designed, and of course the types of activities that naturally appeal to you. That said, certain generalities may hold true: If you are feeling amped up, anxious, or overstimulated, a long walk in nature, a soothing swim, with its rhythmic qualities and the calming sensation of water running over your body, or a gentle yoga class, may be the special sauce to help you settle down, physically and emotionally, and feel more grounded and centered. If you feel the need to blow off steam (as in, you’re feeling frustration, irritation, or anger), you might benefit from an empowering cardio session, such as jogging, spinning, or kickboxing. If you’ve been feeling depressed or isolated, engaging in activities that get you out of yourself and involve others like dancing, playing a team sport, or joining a running or cycling club may provide a mood-refreshing way to reconnect, defuse tension, and help you forget about yourself or put your problems in perspective. Whatever your personal preferences or emotional needs may be, there’s some form of physical activity that will do your mind and body a world of good. Don’t miss out!
Some sources of stress are unavoidable and can take a toll on your peace of mind, but there is also a positive form of stress called “eustress” that is actually good for you. Sources of this “good” kind of stress—for instance, getting a promotion at work or having a stellar athletic performance—can motivate you, improve your performance, and help you grow. So the goal isn’t to eliminate all forms of stress but to manage the negative forms (the ones that cause distress) so that they don’t trigger anxiety, irritation, or withdrawn or frantic behavior—or harm your health.
Over time, chronic negative stress can set the stage for the development or exacerbation of many different medical conditions, from digestive distress and reproductive disorders to heart disease and other chronic diseases, and deeply compromise your emotional health. Stress overload can even harm your gut microbiome: When high cortisol levels continuously course through your body, the bacterial balance in your gut can be disrupted, triggering inflammation. Adding insult to injury, this bacterial imbalance in the gut—known as “dysbiosis”—can send us into a feedback loop that contributes to more stress, anxiety, and depression.
This is yet another reason to get the upper hand on stress in your life, in whatever healthy ways work for you. As you’ve seen, consuming healthy, anti-inflammatory foods and exercising regularly can keep your physiological equilibrium, including your gut microbiome, in a balanced state. Though this helps control your emotional response to stress, it’s not enough on its own. It’s also essential to develop strong coping skills, including problem-solving techniques or tools that help you handle the challenges in your life more efficiently and flexibly. These include a clear, effective communication style, time management skills, the wherewithal to know when to delegate, and the ability to create and maintain healthy boundaries between you and other people and unnecessarily upsetting situations. Being able to perform healthy mind-shifting practices (as you saw in chapter 7) also can help mitigate some of the effects of stress—or at least help you avoid magnifying them.
Alexandra, the New York City writer (see chapter 1) whose anxiety spiraled out of control in 2017, has always been an avid exerciser. But her mounting anxiety inspired her to make some radical changes in her life to reduce her stress level and her exposure to triggers. She took up meditation and yoga, disengaged from social media, stopped watching cable news, and cut back on going out socially as often as she used to. “I became very self-protective—I trained myself not to chase my anxiety or do things that were ramping up my anxiety,” she explains. “Things are much better now—I’m wearing my anxiety a lot more lightly.”
Indeed, it’s wise to cultivate and hone ways to use your personal decompression valve so you can unwind, relax, and restore your emotional equilibrium regularly, as Alexandra does. Here, too, there’s no one-size-fits-all approach that works for everyone. To cultivate and fortify inner calm, it behooves you to try several techniques until you find the one that is most effective for you. Some good ones to start with include yoga or other forms of exercise, guided imagery (conjuring up soothing scenes or experiences in your mind, using as many senses as possible), progressive muscle relaxation exercises (which involve systematically and slowly tensing then relaxing muscle groups from head to toe), and meditation. Various apps and resources for many of these methods can be found online.
As with any skill, these techniques require practice for us to be able to derive the desired effects. So commit to engaging in your technique of choice for an agreed upon time—say, twenty minutes per day. Even if it ends up being only a five-minute decompression session, it’s better than nothing. But in general the longer and more often you practice these techniques, the more stress will be released from your body and mind.
One simple practice that I recommend everyone master and use regularly is deep breathing. This activates your parasympathetic nervous system, which induces the relaxation response. Breathing is such an automatic body function that many of us don’t give it much thought. But the way you do it can have a profound effect on the way you feel and function. People who are particularly susceptible to anxiety, for example, tend to have a faster, shallower breathing pattern that leads to a higher heart rate and increased levels of carbon dioxide in the blood—both of which add to the overall stew of anxiety, fatigue, depression, a feeling of being unfocused, and general malaise.
Many different breathing patterns have been recommended for various purposes, such as relaxing or energizing yourself. The approach that I like for an easy and quick dose of calm to lower stress is the five-six-seven pattern. To do it, close your mouth and slowly inhale through your nose to a count of five seconds, hold your breath for six seconds, then, ever so slowly exhale through your mouth, making a whooshing sound, for seven seconds. With the slow exhale, you may experience an instant sense of relief, your shoulders letting go, and your blood pressure perhaps dropping, too. Repeat the pattern for a total of five to ten complete breaths. Do it two to four times per day—not just when you desperately need to calm down—and you’ll lower your stress reactivity all day long.
Of course, making it a priority to get plenty of good-quality sleep and maintain a consistent sleep-wake pattern (as you saw in chapter 7) are also important steps for dialing down your emotional reactivity. People who experience partial sleep deprivation or insomnia are susceptible to increased emotional reactivity, particularly increased activation of the amygdala (the brain’s fear center) during exposure to emotionally stimulating images or situations. What’s more, rapid eye movement, or REM, sleep, which is most closely associated with dreaming, is important for emotional processing. So if you don’t get enough deep sleep, you may find yourself even more emotionally reactive than usual.
To set the stage for sounder slumber, do some aerobic exercise during the day but not too close to bedtime since vigorous activity may rev you up. Avoid exposure to bright light in the evenings, including TVs and other electronic devices. Dim the lights and engage in activities—reading a not-too-stimulating book, listening to calming music, taking a warm bath, or inhaling soothing scents (see “Fun Facts” in the following box)—that help you unwind from the stresses of the day and shift into a more relaxed state. Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature (ideally, between 60°F and 67°F, according to the National Sleep Foundation). If unwanted light streams into your bedroom, consider installing blackout shades or curtains. If outside noise disrupts your sleep, consider using a white noise machine or an app with soothing sounds from nature (such as wind or waves) to mask it.
If anxiety or stress makes it difficult for you to fall asleep or stay asleep, consider investing in a weighted blanket, which can make you feel grounded, safe, and supported, thus helping you sleep better. It’s a similar principle to swaddling an infant before putting the little one in a crib to sleep. Because a weighted blanket mimics the feeling of being enveloped in a gentle hug, it triggers the release of oxytocin, which, as you have seen, can make you feel calm and relaxed. If you want to try one, look for a weighted blanked that’s appropriate for your body size (about 10 percent of your weight) and that is made of a material that feels good to you. Also, make sure the weight is evenly distributed throughout the blanket to provide firm, constant tactile stimulation across your body.
Whether it’s through diet, exercise, sleep, or stress management, the proper care and feeding of your body can have a significantly positive ripple effect on the way your mind feels and functions. The right dietary patterns, regular physical activity, good quality sleep, and stress-easing strategies can help calm the physical and emotional fires inside you, as long as you’re consistent with these salubrious approaches. It may take some time and effort to fine-tune your lifestyle habits so that they better cater to your body’s needs. And it will, of course, take time for the therapeutic effects to kick in. But it’s worth the wait: Not only will these healthy strategies essentially reset your body’s internal stress meter, but they also are beneficial for your mind, body, and spirit in many other ways. You have nothing to lose with these approaches—and so much to gain.