The Better Mood Recovery Program, Week 3

PHYSICAL SELF-CARE: FOCUSING ON THE BASICS

“No less than two hours a day should be devoted to exercise, and the weather little regarded. If the body is feeble, the mind will not be strong.”

—Thomas Jefferson

Third Week Overview

In this week you will learn ways to take care of and nurture your physical body that can have a profound impact on your mood.

It is the third week of our recovery program and you have reached an important juncture in your journey in healing from depression. Having set the intention to heal and having reached out for support, it is time to take action to alleviate your symptoms and to create a better mood. But how?

The first place most people turn to when they are feeling blue is to their family physician. If your doctor is familiar enough with the symptoms of depression to make a proper diagnosis, he or she will most likely write you a prescription for Prozac (or some antidepressant) and have you return in three weeks. While there is nothing wrong with medication, there is so much more that you can do. Because depression is a complex, multifaceted disorder with a variety of causes, you can approach its treatments from a multitude of directions and modalities.

Take a moment and review the “Five Areas of Therapeutic Self-Care” diagram on page 141. Over the next ten weeks, you will learn how each of these areas and their corresponding self-care activities can be used to change your brain chemistry and your mood. I encourage you try a combination of these mutually supportive therapies, as you will greatly maximize your chances of attaining the healing that you seek.

Now let's begin with the first step in attaining a better mood—taking care of and nurturing your physical body.

The Body-Mood Connection

Although depression is characterized as a mood disorder, it primarily affects the physical body. Those of who have suffered from clinical depression know the agonizing physical symptoms—loss of appetite, disruption of sleep, the inability to experience pleasure, fatigue, lethargy, heaviness, agitation etc. In many ways, being depressed is like having the emotional flu. Conversely when we feel great physically—full of vitality, energetic, awake, alert, etc.— it is almost impossible to be in a bad mood. As my friend Beth who suffers from anxiety is fond of saying, “It is so much easier to think positively and be calm and serene after a good night's sleep!”

Another reason to focus on physical health is that it deals with out most basic human needs—food, water, air, sleep, touch, and movement. Because these needs are so elemental, many people take them for granted. But when we ignore our basic needs, the entire body—as well as our mood—gets thrown out of balance. (Researchers like Candace Pert have shown that “molecules of emotion” are located not just in the brain, but throughout the body.)

Because of this body-mood connection, I believe that the starting point of healing from depression and anxiety is physical self-care. In the pages that follow you will learn the many ways you can create a better mood by nurturing your physical body.

1) Exercise

Exercise—any physical activity that promotes endurance, flexibility or strengthening—is a natural antidepressant. The latest scientific research demonstrates that as little as three hours a week of regular exercise reduces the symptoms of mild to moderate depression as effectively as Prozac and other medications. Aerobic exercise in particular improves circulation, brings increased blood flow and oxygen to the brain, and releases endorphins, the body's natural painkilling chemicals. The only “side effects” of aerobic exercise are a stronger cardiovascular system and better overall health. Even if you have no history of mood disorders, regular exercise can profoundly improve the quality of your physical, mental and emotional well being.

 

10 Basics of Physical Self-Care

Here are ten basic, physical self-care habits that can form the foundation of your physical self-care brain wellness program.

1) Avoid putting junk in your body. Start with the obvious poisons like tobacco, alcohol and hard drugs. In addition, eliminate processed foods such as soft drinks, diet sodas, candy, cookies, cakes, prepared entrees made with artificial ingredients, etc.

2) Give the body sufficient exercise, at least 20 minutes a day, 5 days a week, in a way that breaks a sweat. The practice of yoga is particularly helpful in conditioning the body, calming the nervous system, and balancing the emotions.

3) Drink plenty of water, at least 64 ounces a day (one ounce for every two pounds of body weight) and more if you are active. Make sure the water is pure, not city water. To ensure this , use a good water filter.

4) Meet your body's need for sufficient sleep with a regular and consistent sleep schedule.

5) Eat a diet that contains of wide variety of fresh unprocessed foods, buying organic whenever possible. Make sure you eat at regular intervals to keep the blood sugar stable.

6) Learn how to properly oxygenate your body through deep, diaphragmatic breathing.

7) Get enough exposure to natural light (morning hours are best), especially if you have SAD (seasonal affective disorder). Light boxes are therapeutic for some people.

8) If you wish to explore medicine that directly impacts your brain chemistry, whether it is conventional antidepressants such as Prozac or Zoloft; herbal remedies such as St. Johns Wort and Kava Kava; or amino acids such as 5-HTP or SAMe, find an appropriate prescriber or nutritionally oriented physician to work with.

9) Find a way to fulfill your body's need for touch through hugs or therapeutic massage.

10) Take care of you daily hygiene by showering, shaving, combing your hair, brushing your teeth, etc. Feeling clean will help you to feel better.

 

Regular exercise has become the central pillar of my recovery program. On weekdays, I ride my stationary bike and lift weights in the morning and swim in the evening. On weekends I take long walks in the forest. When I miss my routines for even one or two days, I am more likely to become depressed or anxious. When I return to my schedule, the self-doubts, fears, and anxieties melt away.

One of the reasons that many people resist exercise is that they see it as something arduous and unpleasant. To heal this resistance, see if you can turn the “e” in exercise to “e” in enjoy. In other words, strive to make exercise fun by connecting it to activities that give you pleasure. Such activities might include:

Another way to approach exercise is to incorporate it into your daily activities. (Our agrarian ancestors didn't need to set aside special times in their busy schedules to work out at the gym.) Some mundane activities that will give you a natural workout include:

 

Mark's Story: Exercise Makes the Difference

At the age of thirty-seven I fell into a major depression. I lost my ability to concentrate, my ability to sleep, and my ability to feel any type of joy or pleasure. Everything that had color became gray. Eventually, I got stabilized on medication. Yet, I never felt that I had regained the joy of living that I had before the depression struck.

Then I enrolled in Douglas's depression support group and learned about the value of exercise in relieving the symptoms of depression. I decided to try something different. One thing that Douglas emphasized during class was to set and monitor goals. So, I chose to make engaging in a regular exercise routine my primary goal and mission.

My first step was to start a regular workout program at my health club consisting of a one hour aerobic class, three days a week. Each week at the support group, I told my fellow members of my exercise goals. Knowing that I would have to report my results the following week made me want to follow up on my commitment. Being held accountable to others was a huge support in keeping me motivated.

After three months of sticking with my plan, I have noticed amazing results. My mood has improved, I feel less on edge, and I am more confident. Under my psychiatrist's guidance, I plan to discontinue my medication. There are times when I don't feel like working out, but I remind myself that exercise has become my “mental health therapy.” The improvements in my cardiovascular fitness are just an added bonus to being free from depression and anxiety. Nothing I have done so far has given me such a return on the time invested.

 

Our bodies were made to move. Whether it is a daily walk in the park, a water aerobics or yoga class, or dancing to your favorite music, get into motion. Start with small steps and remind yourself that you don't have to be perfect. At the pool where I swim, I see many disabled, elderly and overweight people taking part in water exercise classes. Even if you have a physical disability or carry extra pounds, it is usually possible to engage in some form of movement.

2) Balancing mood through diet

A major key to keeping depression at bay is to get your nutritional needs met through eating a balanced diet of healthy foods. Good nutrition supports the optimal functioning of your brain and body. Eat as much organic produce as possible to minimize the intake of chemicals and preservatives which can cause problems, especially in sensitive individuals.

Another part of nutritional self-care means cutting back on the sweets. Studies have shown that too much sugar can foster anxiety as well as depression. Excessive intake of sugar may also weaken your immune system, foster allergies and increases the risk of diabetes and reactive hypoglycemia.

In her book Potatoes Not Prozac, Kathleen DesMaisons, Ph.D., an addiction and nutrition expert, claims that many people who are prone to addictive disorders, as well as to depression, are also sugar sensitive—i.e., they have a special body chemistry that reacts in extreme ways to sugar and refined carbohydrates. The reaction throws off not only the blood sugar levels, but also the levels of serotonin and beta-endorphins (nature's pain killers) in the brain. This in turn causes an inability to concentrate; creates feelings of exhaustion, hopelessness and despair; and contributes to confusion, irritability, and low self esteem—i.e., symptoms of clinical depression! Such symptoms lead the person to seek out a “sugar fix” to relieve their distress. This of course sets up the classic “vicious cycle,” leading to emotional ups and downs as their blood sugar levels wildly fluctuate.

Fortunately, DesMaisons has discovered that eating the right foods at the right times can often bring the body and emotions back into balance. Her dietary recommendations include:

DesMaisons’ plan has achieved a high success rate with recovering alcoholics as well as with people with mood disorders who are striving for emotional stability.

Another book that I have found helpful is the Metabolic Body Type Diet by William Wolcott. This book is based on the simple but often overlooked premise that different individuals process the same foods and nutrients differently. For example a high carbohydrate diet can help one person lose weight, while a second person eating the same food gains weight. One person's meat becomes another's poison.

Wolcott introduces a technology called metabolic typing that analyzes individual nutritional differences. Metabolic typing contends that a number of factors—including the oxidative system (how slowly or fast you burn foods) and the autonomic nervous system (whether you are sympathetic or parasympathetic dominant)—work together to determine your dietary needs. This analysis identifies three general metabolic type categories: 1) the protein type (high protein, high fats and oils; low carbohydrates); 2) the carbo type (low protein, low fats and oils, high carbohydrates) and 3) the mixed type (requires a relatively equal ratio of proteins, fats and carbohydrates).

Wolcott's metabolic-type self-test revealed that I was a protein type who had been living on a carbo diet. When I switched to the protein regimen and added meat back into my diet, my need for sleep declined, my energy increased, and my weight dropped. (My wife, on the other hand, gets much better results from eating more carbohydrates and less protein, demonstrating that one size does not fit all.)

In addition, other researchers have discovered a connection between depression and food sensitivities. Although no one has proven that allergies can cause depression, it seems reasonable to assume that allergies can aggravate a depressive condition since both conditions are known to involve similar biochemical imbalances (low norepinephrine and high aceytlcholine levels). Common food allergens include dairy products, wheat, and corn. If you think you might have food allergies, consult a doctor who specializes in allergies or environmental medicine.

3) Maintaining Adequate Water Intake

To maintain healthy body functioning, it is important to drink adequate amounts of fluids, at least two quarts a day. Your body is composed of 70 percent water while the brain is about 90 percent water. Water is essential to proper metabolism, circulation and elimination. It flushes out toxins and restores chemical balance to cells, tissues and organs. Many of my clients have reported a direct improvement in mood, as well a cessation of physical symptoms such as headaches, once they increased their fluid intake.

Research indicates that one should drink at least 64 ounces of water a day (ideally, one ounce for every two pounds of body weight) and more if you are active. Adults lose nearly two to three quarts of water a day (12 cups) through breathing, perspiration and urination.

Your thirst reflex is not a good indicator of dehydration; by the time you feel thirsty you should have been drinking water hours ago. This is why many people are chronically dehydrated and don't even know it. A mere 2 percent drop in water can trigger fuzzy short term memory, trouble with basic math, or difficulty reading. For many people, the thirst mechanism is often mistaken for hunger. A University of Washington study showed that one glass of water shut down midnight hunger pangs for almost 100 percent of dieters.

When I presented this information at one of my seminars, a man who leads river raft trips through the Grand Canyon informed me that whenever his passengers become irritable, anxious, or angry, he gives them water and watches their mood even out. The moral of the story is clear—don't wait until you are thirsty to drink. Carry water with you and sip it throughout the day. Your body and your mind will thank you.

4) Exposure to Natural Light

Another physical need of the human body is getting enough exposure to natural light. For those people who are light-sensitive, inadequate exposure to light can create depressive syndromes such as Seasonal Affective Disorder (SAD) (See Appendix A for to learn more about SAD). If you live in a dark climate and suffer from SAD, use full-spectrum lights to enhance your exposure to light. (I use halogen lamps because I prefer the warmer, yellow color.) An hour of exposure to outdoor light in the early morning can also make a difference. Some people find that lighting candles on a dark winter's day brings warmth and coziness to the otherwise dreary environment.

5) Sleep Hygiene

Part of staying physically balanced means developing regular sleep patterns that give you adequate amounts of rest. (Studies show that most Americans are sleep-deprived.) Try to develop a sleep schedule—a regular time of going to sleep and arising—and stick to it. Sleep irregularities are among the early warning signs of both mania and depression. These symptoms include:

Depressed individuals who sleep too much will inevitably tell you that they wake unrefreshed, indicating that their sleep is not restorative sleep.1 It also seems that people with depression experience an excessive amount of dreaming sleep. The sleep they're getting is primarily this lighter stage of sleep, during which rapid eye movements and dreams occur. There seems to be something about an excess of rapid eye movement sleep that is depressigenic—i.e., makes people feel depressed.

Also, researcher Eve Van Couter discovered that when volunteer students were deprived of sleep, their brains did not effectively process glucose, the major fuel for brain function. As we saw earlier, impaired sugar metabolism is linked to depression.

Sleep medication and tranquilizers can be useful in trying to break a pattern of sleeplessness, but they are only designed for short-term use. Low doses of the antidepressant Elavil (25 mg. before bedtime) can induce sleep over longer periods without risking addiction or dependence. Behavioral changes, such as those listed in the book No More Sleepless Nights by Peter Hauri, can be extremely effective. These include:

In addition, you may wish to be evaluated at a sleep clinic to rule out the possibility of physical problems such as sleep apnea. (Sleep apnea is a temporary suspension of breathing that occurs repeatedly during sleep. It often affects overweight people or those who have an obstruction in their breathing tract.)

For those who have experienced crippling insomnia, establishing regular and restorative sleep patterns makes all the difference in the world. In this regard, here is a an affirmation/mantra that was given to me by a client who repeated it to himself as he drifted off to sleep in order to stop his obsessive thoughts. It was written by a 13th century English monk and reads as follows:

All shall be well,

and all shall be well,

and all manner of things shall be well.

6) Abdominal Breathing

One of the most powerful ways to impact the emotions and the involuntary nervous system is through the breath. In Sanskrit, the word for breath is prana, which also means “life” or “spirit.” Most people in our society breathe rapidly and shallowly, using only the upper part of their chests. This is especially true for depressed individuals, whose life force is at a low point, as well as for people who are chronically anxious.

Abdominal breathing (also called diaphragmatic breathing) involves using your entire chest and abdominal cavity to breathe. Through abdominal breathing, you can slow down racing thoughts and increase the body's life force and vitality. Here is a brief description of the process.

Sit in a comfortable position with your spine straight (you can also do this lying on your back). Place both hands on your abdomen, right beneath your rib cage, with the fingers of each spread out and just touching each other. Now inhale slowly and deeply, sending the air as low as you can. You can feel as if you are pushing the air downward toward your tummy. As the belly fills up with air, you should notice that the fingers of your two hands slowly move apart.

When you have taken a full breath, pause momentarily and exhale slowly through your nose or mouth. As you do so, you will see your abdomen deflating, much like a balloon that is having its air let out. Let your body go limp as you watch the hands on your abdomen slowly return to their original position. Your fingers should be touching again.

Try repeating this eight to ten times, breathing deeply and slowly without gulping in air or letting it all out at once. You may wish to count to four on the inhale and to eight on the exhale, or whatever rhythm works best for you.

I first learned about abdominal breathing in a yoga class many years ago. You can also learn diaphragmatic breathing techniques in any stress reduction clinic, biofeedback center, pain clinic, or from any individual who has practiced yoga.

7) Physical Touch

Human touch is profoundly healing for body, mind and spirit. Phrases such as “you touched me” or “keep in touch” reflect the importance of human touch to emotional and physical health. There are many ways of experiencing touch—by extending a hug, holding a hand, or giving a back rub.

One way to receive healing touch is through therapeutic massage. Massage relaxes the muscles, promotes lymph drainage and stimulates the immune system. While many people are “touch hungry,” those folks who have experienced physical violence or sexual abuse may need to be “desensitized” to their negative conditioning around touch before they feel safe and open to its healing benefits. If you think this may be true for you, consult with your therapist or someone who specializes in treating survivors of physical/sexual trauma.

For myself, my weekly massages provided one of the few moments of relief I had during the ongoing torment of my clinical depression. Now that I am in recovery, I still nurture myself through massage as well as regular soaks in the hot tub.

This Week's Goals/Assignments

Here are your assignments for the upcoming week:

1. Fill out the Physical Self-Care Wellness Inventory on page 188. This will help you to see how well you are caring for your physical body. I suggest that you buy a simple journal or spiral bound notebook which you can use to record your answers to this questionnaire and the others that will follow. You can also use your “Better Mood Journal” to record any thoughts, feelings or important events that occur during the remainder of the program.

2. Complete the Physical Self-Care Goal Sheet that follows. Then choose a self-care activity as this week's goal.

3. Start to track how many ounces of water you drink each day. On a blank sheet of paper, note each time you take a drink and how much fluid you have ingested.

Ongoing Self-Care Activities

 

Physical Self-Care Wellness Inventory

The following questions are designed to help you to assess how you are doing in the area of physical self-care. You can answer in the spaces provided or in your Better Mood Journal.

1. Overall, how would I rate my physical health? (1 low, 10 high). How is my energy level? Do I think of myself as primarily ill or well?

2. What types of physical activities make my body feel good? What types of exercise do I participate in? How many times a week?

3. How would I describe my relationship with food? What kinds of food comprise the majority of my diet? Are there any “comfort foods” that I turn to when I am stressed?

4. Do I eat the right amount of food given my activity level? Do I drink sufficient water (8 glasses a day)?

5. How is my sleep? Do I sleep too much, too little, or about right? How is the quality of my sleep? Am I able to sleep through the night without interference, or do I get up periodically? How do I feel when I awaken in the morning—refreshed or still tired?

6. Many people use a shower, bath, whirlpool, hot tub, or pool to soothe them physically and emotionally. Do I use water therapy in this way? If not, how might I do so?

7. Are there aspects of my health that prevent me from feeling vital and alive. If so, what are they?

8. Are there any exercise or health habits I would like to develop? Any that I would like to eliminate?


 

 

Creating Goals For Physical Self-Care

Using the list of physical self-care activities below as a guide, write down those that you are already practicing and those that you would like to incorporate into your life.

Physical self-care strategies I am already using:

1. _______________________________________________________________________________

2. _______________________________________________________________________________

3. _______________________________________________________________________________

Physical self-care strategies that I would like to make part of my life:. Examples include, “I would like to exercise three times a week,” or “eat a better balance of fruits and vegetables,” or “sleep more regular hours.”

1. _______________________________________________________________________________

2. _______________________________________________________________________________

3. _______________________________________________________________________________

Now take one of these activities and make it a goal for the coming week or a future week.

 

 

My Goal Sheet for Week 3

This week's starting date_____________My coach/buddy ____________________

Date/time we will connect _____________________________

Goal or Goals _______________________________________________________

___________________________________________________________________

___________________________________________________________________

Benefits of attaining this goal____________________________________________

___________________________________________________________________

___________________________________________________________________

Action plan _________________________________________________________

___________________________________________________________________

___________________________________________________________________

Ongoing goals (check off the ones as you accomplish them)

______ Read my vision statement daily (upon awakening or before bed)

______ Chart my moods in the Monthy Mood Diary

______ This was my average mood on the better mood scale.

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How was my mood this week?

Record your moods below for each day of the week.

  Day Mood    Comments
  Mon    
  Tue      
  Wed    
  Thu    
  Fri      
  Sat    
  Sun    

 

1 Sleep may also be a way of escaping emotions that are too painful or that a person doesn't want to feel.