The Better Mood Recovery Program, Week 10

CREATING A HEALTHY LIFESTYLE

“Those who do not find some time every day for health must one day sacrifice a lot of time for illness.”

— Father Sebastian Kneipp

Tenth Week Overview

In this week you will learn specific daily lifestyle habits that will help to elevate your mood.

In the previous nine weeks of our better mood program I have shared various self-care strategies that are designed to rewire the brain and help you to heal from anxiety and depression. These strategies have focused on the physical, mental/emotional, social and spiritual dimensions of life.

This week we are going to look at other self-care activities that do not fit under any of these four categories. I have organized them under the theme of “lifestyle habits” because they represent specific behaviors that can be incorporated into our daily lives to enhance mood.

Let's explore some of these miscellaneous “mood boosters” now.

Lifestyle Habit #1: Structure and Routine

Having the right amount of structure/routine in one's daily life is essential to good mental health. Optimal amounts of structure decrease anxiety and help stabilize emotions. Without adequate structure and a regular routine, people prone to depression can become excessively involuted and self-absorbed. This is why I awaken, exercise, eat, see students, write, and socialize at approximately the same time each day. Having a stable routine gives me something to look forward to. Having something predictable to focus on each day calms my anxiety as well as any tranquilizer—and without the side effects.

The importance of structure in alleviating anxiety took on critical importance during my last depressive episode. Weekends were my most challenging times because of the lack of structure. During the week, I was able to attend a full-time day treatment program which gave me a way to focus my agitated energies. There was no such-built in structure on the weekends—and so I did my best to improvise. Making appointments with friends to go hiking was my best strategy. And on Sunday mornings I attended worship services at The Living Enrichment Center, not because of my spiritual hunger, but because I needed someplace to go. It was this decision, that ultimately attracted the support group that saved my life.

Lifestyle Habit #2: Connect with the Natural World

Scientific evidence reveals that any contact with nature, even a view of trees from a window, can improve coping ability and mental functioning in people who are ill or under stress. Whether it's watching a moonrise over a mountain peak, a sunset over the ocean, or simply taking a leisurely walk in your city park, spending time in nature can elicit a healing connection to Mother Earth.

Hiking in nature (in the woods, on the beach, etc.) is particularly beneficial because it combines the advantage of aerobic exercise with the feelings of awe and reverence that accompany being the natural world. As John Muir, the founder of the American conservation movement said over 100 years ago,

“Climb the mountains. Get their glad tidings. Let the winds and the storms blow their energy into you, and watch your cares drop off like autumn leaves.”

Lifestyle Habit #3: Be Exposed to Natural Light

Part of connecting to nature means getting enough exposure to natural light. Many spiritual paths teach that God and light are one and the same. For those people who are light-sensitive, inadequate exposure to light can create depressive syndromes such as Seasonal Affective Disorder (SAD). If you live in a dark climate and suffer from SAD, use full spectrum lights or halogen lamps to enhance your exposure to light. In addition, spend as much time outdoors as you can. Research shows that early morning light is the most beneficial. If you find yourself working indoors try to have your desk situated by a window. (Please refer to Appendix A to learn more about SAD.)

Lifestyle Habit #4: Employment and Right Livelihood

When asked for his definition of mental health, Sigmund Freud replied, “The ability to work and to love.” Employment is therapeutic for a variety of reasons; it draws us outside of ourselves, brings us into contact with other people, and gives us a sense of identity and independence (volunteer work provides many of the same benefits). As one middle-aged woman recently testified at a mental health conference, “The most important factor in my recovery was being able to return to work!” Conversely, I have seen depression brought on by a person's lack of employment, or being involved in work that does not express a genuine passion.

Work issues are prominent in the depression support groups I run. Prior to joining the groups, many of my clients had been forced them to leave their jobs or careers because of their depression and anxiety. As they have healed, their desire and ability to work has reemerged. Returning to work has constituted a huge turning point in their recovery.

A more challenging group of clients are those folks whose high-stress (and sometimes abusive) jobs are “driving them crazy,”—i.e., exacerbating the symptoms of anxiety and depression. To leave the job, however, would mean replacing job stress with financial stress.1

The ideal way to resolve such a dilemma is through the practice of “Right Livelihood,” which originated as an aspect of the Buddha's Noble Eightfold Path to enlightenment.2 To practice Right Livelihood means finding a way to earn a living in which what you do is beneficial to humans, animals, plants and the earth—or at least minimally harmful. Right Livelihood is about expressing your natural talents and gifts in a way that brings you joy, blesses the world, and produces a livable income. It is an expression of your deepest self that:

Many practitioners of Right Livelihood agree on three basic principles to use as guidelines.

1) I do this work because I love doing it; I feel full when I am doing it.

2) I find my primary reward in serving people and creating something meaningful, beautiful or useful. (Depending on the profession, one may still earn a high income, but making money is not the primary motivation.)

3) My relationship to my fellow human beings and the planet is based on sharing and cooperating, rather than competing.

Clearly, the passion and joy that we experience when we find our Right Livelihood are wonderful antidotes to depression as well as blessing for the entire planet.3

Lifestyle Habit #5: Find Time to Relax

While work is therapeutic, too much work and not enough play can get us out of balance. In recent years, Americans have become more and more time deprived. We live in a type A” culture where people become, in the words of John Bradshaw, “human doings” and not “human beings.” (Remember when Sundays were a day of rest?) As an antidote to such overactivity, see if you can schedule in periods of time to relax and just “be.”

 

Marie's Story: Overcoming Depression Through Right Employment

At age 51, I had become very isolated as I searched for satisfying employment. Although I had received a formal education in art and had worked within women's social-change arenas for years, I was struggling to find a fit as I wandered through lengthy periods of unemployment, debt and dissolution.

In the absence of work my sense of self worth became easily confused. I began to doubt myself, to wonder about my reason for doing things, and to blame myself for failure to do things right. My feelings of alienation grew, and the need for distraction and avoidance mounted. Comfort from overwhelming anxiety became my daily goal. Food, drink and sleep became my best friends. I became disconnected from all of the healthy structures of my life.

Finally, I decided to break my self-imposed isolation and admit that I was deeply depressed and needed help. I joined Douglas's support group where I was able to regain a larger perspective as I listened to other people who were struggling through their own dread and darkness. I was challenged to identify my own defeating patterns, and to create a positive vision and work at affirming my life every day. It felt good to ask for help and to receive it. I reached out to employment service support and found non-judgmental people who validated my efforts and provided networking ideas for my job search.

After I succeeded in finding a meaningful job and work with people with whom I could identify, I was able to relax deep within myself. I could lower my shoulders and let air deep into the bottom of my stomach. My feelings of alienation lessened. My creative energy began to flow again. I began to regain my confidence and belief in my true nature. I got back in touch with my wealth of life experience and skills which I share within my new job. I was able to see and feel the life surrounding me, and to feel grateful to be alive. I find myself saying “Thank you, thank you, thank you,” many times a day.

 

Relaxation comes in many forms:

Find your own special activity and structure it into your day. While it can be tempting to use alcohol to relax (or to use caffeine to focus), you run the risk of developing a new problem—chemical dependency. If you feel stressed, there are a variety of tools—e.g., deep breathing, exercise, massage, hydrotherapy, listening to relaxing music, positive self-talk, prescribed medication, etc.—that can help you to relax (see also the stress reduction techniques listed in Week 11).

Lifestyle Habit #6: Find Ways to Experience Pleasure

Related to the idea of relaxing is that of experiencing joy or pleasure. Since the absence of pleasure is one of the key symptoms of depression, incorporating pleasure into your life will be curative. Take a look at the table of ideas for pleasurable ideas on the opposite page. As you read over the list, see if you can locate activities that are enjoyable, used to be enjoyable, or might be enjoyable—e.g. eating a good meal, working in the garden, nurturing a pet, spending time with friends, etc. Write them down in the space provided or in your better mood journal. You can also ask yourself the following questions:

 

Ideas for Pleasurable Activities

The following are some ideas for actiivities that can help you to bring more joy and pleasure into your life. While reading over the list below, ask yourself, “What things that are pleasureable, used to be pleasureable, or might be pleasureable?” Then write down four choices in the space provided.

 

Four Activities That Could Bring Me Joy

1._________________________________

2._________________________________

3._________________________________

4._________________________________

 

At the end of this chapter, you will be provided with a week-at-a-glance planner that you can use to schedule enjoyable activities into your weekly routine. Even finding just one pleasurable activity a week can be an important first step in feeling better.

Another way to experience pleasure in the here and now is to create “a library of positive memories.” Make a list of the happiest moments of your life. Then, go back in time and relive them, using your five senses to recreate, in exquisite detail, those joyful experiences. Because the brain cannot differentiate between a real or imagined experience, its neurochemicals will take on the same mood enhancing configuration as they did when the original events occurred. In the future, when you are feeling a bit low or need some inspiration, you can re-experience those pleasant memories.

Lifestyle Habit #7: Get Into the Flow

When I was in graduate school, I ask one of psychology professors how she helped her clients heal from depression.

“That's easy,” Carolyn replied. “The cure for depression is involvement.”

Reflecting on my professor's comment, I realized that the ending of my previous depressive episodes had always corresponded to committing myself to a new creative idea or passion. I also realized that when I was truly involved in an all-consuming project or focus, I did not experience the symptoms of depression and anxiety.

Recently this truth has been corroborated by psychologist Mihalyi Csikszentmihalyi at the University of Chicago. “Mike” as his friends call him, has written a groundbreaking book called “Flow: The Psychology of Optimal Living. According to Mihalyi, activities that produce flow are a remedy for “psychic entropy”— the mind's tendency to become random and chaotic when not focused on a purposeful goal directed activity.

Here are Mihalyi's eight conditions of flow.

1. You have a clearly defined goal with clear steps on how to reach it.

2. You receive clear and immediate feedback about how you are doing. For example, in tennis, each time you hit the ball, you quickly discover how good a shot it was. Knowing how well you are doing keeps you focused on the activity.

3. The challenge of the activity matches your skills. For example, in tennis, your skills would be matched to the opponent's, so that you avoid being overwhelmed by the other person's superior ability or being bored because you are so much better.

4. You feel totally focused on what you are doing. Your focus becomes a single beam of concentrated attention.

5. You live in the present moment. Worries or concerns about the past or future do not intrude on your consciousness. Neither do the concerns or frustration of daily life.

6. You lose yourself in the activity, no longer aware of yourself as a separate entity. Self forgetfulness leads to a sense self-transcendence. Even though you forget yourself in the moment, you can look back at yourself afterwards and feel good about what you have accomplished.

7. You feel a sense of control and mastery over your experience.

8. Your experience of time is transformed. Hours may become condensed into minutes; or a few seconds can seem to take fifteen to twenty minutes. An example of the latter is a dancer doing a pirouette where so much is packed into the moment that time becomes expanded rather than condensed.

Flow is the experience of true enjoyment. In flow, you take on new challenges and learn new skills, always moving forward toward higher levels of complexity and mastery (e.g. the chess player who plays at greater levels of skill as he improves his game).

Look to your own life. Have you ever experienced a time when you were so focused and motivated that you felt alert, energized and free of self-consciousness? Were you dancing, gardening, working on a car, playing an instrument, hiking in nature, experiencing a runner's high, playing your favorite sport, making a painting or sculpture, singing in a choir, teaching a child, or helping another? See if you can identify any prior flow experiences and then bring them into your daily or weekly routine.

Of course, in the midst of a severe depressive episode, getting into “the flow” may be next to impossible. The best time to use flow as an antidote for depression and anxiety is when you are on the other side of your depression. Then, it can be used as “preventative medicine,” a way of strengthening your psychological immune system so that dips in mood become less likely.

Lifestyle Habit #8: Tune Into the Healing Power of Music

Aside from “soothing the savage beast” music can be a balm for those suffering from depression and anxiety. Many spiritual traditions use sound vibrations to calm the emotions, still the mind and restore hope and inspiration. (Think of the soothing, reverential tones of Gregorian Chants.) Music can be very relaxing, especially when it follows a rhythm of sixty to seventy beats per second. Or, a rousing symphony can be just what you need to feel renewed and energized.

In my recovery program, I make use of music in two ways. In the morning, I play inspiring music (e.g. Johnny Nash's “I Can See Clearly Now”) to motivate me as I ride my stationary bike for a half hour. In the evening, I play classical music or a relaxation tape to help me wind down for the day.

Ask yourself, “What kind of music makes me feel better?” Make a catalog of your favorite musical tunes, noting which ones are relaxing and which can be used for inspiration. You may want to make a tape or CD which you can play as a daily mood enhancer.4

Lifestyle Habit #9: Take Time to Laugh

“A merry heart doeth good, like a medicine.”

—Proverbs, 17:22

The proverb “Laughter is good medicine” is more than just a saying. Ever since Norman Cousins published his memoir Anatomy of An Illness, in which he describes how he healed himself of a fatal illness through Vitamin C and laughter, the medical world has come to recognize the therapeutic value of humor. William Fry Jr., who has done research on the physiology of humor for the past 45 years, lends support to Cousin's notion that laughter is like “internal jogging.” Laughter enhances respiration and circulation, oxygenates the blood, decreases stress hormones in the brain, and prevents “hardening of the attitudes.”

There exist numerous accounts in the medical literature of peopled healed through humor. In one instance, an elderly man was admitted to a hospital suffering from severe depression, having not eaten or spoken for several days. Shortly afterwards, a clown entered his room, and within thirty minutes the patient was laughing, eating, and talking.5 In recent times, the most well-known practitioner of humor and medicine is Patch Adams, M.D., who adopts the role of the clown to bring joy and healing to the patients of his “Gesundheit Institute” in rural West Virginia (www.patchadams.org).

There are many ways that you can build laughter into your daily environment—having a humorous poster in your home or at the office, reading your favorite comic strip, engaging in joke-telling with your friends, receiving jokes over he Internet or renting films of your favorite comedians. Remember, “S/He or laughs, lasts.” It is almost impossible to feel depressed or anxious in the middle of a good belly laugh.

Lifestyle Habit #10: Bring Beauty Into Your Life

The ancient Greeks knew of the healing power of beauty. Beauty brings balance and harmony to the soul. There are other ways to bring beauty into your environment—through beautiful works of art (which can be reproductions and therefore inexpensive), photographs of your favorite spots in nature, nature calendars, having beautiful fabrics, rugs and tapestries, and surrounding yourself with your favorite colors. According to Dr. Andrew Weil, bringing flowers into the home is a wonderful way to delight the senses and raise our spirits. Working in the garden, strolling in a park, or hiking in the forest is another way to experience the beauty of nature.

 

Take Time for 12 Things

by Paul Bragg

1. Take time to Work;
it is the price of success.

2. Take time to Think;
it is the source of power.

3. Take time to Play;
it is the secret of youth.

4. Take time to Read;
it is the foundation of knowledge.

5. Take time to Worship;
it is the highway of reverence and washes the dust of earth from our eyes.

6. Take time to help and enjoy Friends;
it is the source of happiness.

7. Take time to Love;
it is the sacrament of life.

8. Take time to Dream;
it hitches the soul to the stars.

9. Take time to Laugh;
it is the singing that helps with life's loads.

10. Take time for Beauty;
 it is everywhere in nature.

11. Take time for Health;
 it is the true wealth and treasure of life.

12. Take time to Plan;
 it is the secret of having the time for the first eleven things.

 

Lifestyle Habit #11: Practice Time Management

Creating a healthy lifestyle means bringing certain mood-enhancing habits and activities into our daily lives. The key to making this happen is learning to manage our time. Taking the time to plan is the secret to creating a lifestyle that truly nurtures and supports us (See Paul Bragg's poem on the facing page).

The book that introduced me to time management was Alan Lakein's classic “How to Get Control of Your Time and Your Life.” According to Lakein, successful time management begins with looking at your values and making a list of what is truly important in your life. After listing a list of those things that are most important, Lakein suggests that we prioritize our goals by assigning an “A” to those items that have high value, a “B” to those items that have medium value and a “C” to those that have the lowest value. Finally, Lakein suggests, make a daily “to do” list, blocking out periods of time each day to work on those high priority A's goals.

Lakein's effective ABC priority system is based on the famous 80/20 rule, discovered by Italian economist Vlifredo Pareto who noted that if all items are arranged in order of value, then 80 percent of the value would come from 20 percent of the items. (I learned this first hand in sales when I discovered that 80% of my income came from 20% of my customers).

The 80/20 rule explains why 80% of are tasks in life are C's (low value goals), and that although A's takes more work than C's, they create far more value in the long run. For example, let's say that you make regular exercise one of your high priority goals. Although you may prefer to clean out your desk as opposed to working out at the gym, the “A” goal of physical exercise will pay the greater dividends in helping you to heal from depression. That is why exercise should always be a part of your daily routine.

This Week's Goals/Assignments

These are your assignments for the coming work:

1) Fill out the “Assessing My Lifestyle Habits Inventory” and the “Lifestyle Habits Goals Sheet.”

2) On page 308 is a week-at-a-glance schedule that I call the “Healthy Lifestyle Activities Schedule.” Make a number of photocopies (or create your own). Then, after answering the questions in the Lifestyle Habits Inventory, write down those self-care activities that have become part of your daily routine. Please include everything that you have been doing over the past ten weeks—including daily exercise, reading your vision statement, seeing your counselor, attending a support group, filling out your daily mood log, your daily spiritual practice, going to church, etc. Also include the list of pleasurable activities from the chart on page 297.

An example of my own Healthy Lifestyle Activities Schedule is provided on page 309. This will give you a model of what to put in your own schedule so that you can make your healthy lifestyle habits an integral part of your recovery plan.

Ongoing Self-Care Activities

 

Assessing My Lifestyle Habits

Please take a few moments to answer the following questions as a way of assessing the quality of the lifestyle habits in your life.

1.  How much structure and routine do I have from day to day? Too much, too little or just the right amount?

2.  Do I find time each week to connect with the natural world?

3.  Are there any health risks that I am taking? What is my daily intake of alcohol, tobacco, or other potentially harmful substances? If these habits exist, how am I trying to change them?

4.  Do I take time to relax and just be? Do I take time for personal reflection? How do I renew myself?

5.  What truly nutures me? What brings me joy? What activities are fun or pleasurable? Am I finding time for them in my life?

6.  Do I have any creative outlets? If so, what are they?

7.  What kind of music makes me feel better? Which music most relaxes me? Which music most energizes and inspires me?

8.  Are there any colors that I am attracted to? What colors do I like to wear or have in my environment?

9.  What makes me laugh? How often do I laugh? Am I around people who share my sense of humor?

10. Have I discovered my gift(s) to the world? Am I using them? Do I have the opportunity to express them in my work?

11. What would I do if I knew I couldn't fail?

 

 

Creating Goals for Lifestyle Habits

Using the answers from your wellness inventory and the topics discussed in this chapter, write down the lifestyle habits you now have and the habits that you would like to incorporate into your life.

Positive lifestyle habits I am already practicing:

1.

2.

3.

Positive lifestyle habits I would like to make part of my life:

1.

2.

3.

 

 

 

My Goal Sheet for Week 10

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    

 

 

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1 One option to replace lost income is to apply for social security disability (SSD). See chapter 12, Financially Surviving A Depressive Episode.

2 The other 7 elements of the Eightfold Path are Right View, Right Thinking, Right Speech, Right Action, Right Diligence, Right Mindfulness and Right Concentration.

3 Two excellent resources on finding fulfilling work are Wishcraft by Barbara Sher and Your Heart's Desire: Instructions for Creating the Life You Really Want, by Sonia Choquette.

4 An example of a wonderful song that provides hope and encouragement is Billy Joel's “You're Only Human,” also known as “Second Wind.”

5 Moody, Raymond, Laugh After Laugh, Jacksonville, Headwaters Press, 1978, pg. 21.