Strengthening Your Mental Health

By Dr. Julie Alonso, WCI Columnist

Wellness, mental health, and emotional well-being have all been buzzwords in recent years in pop culture as well as in medicine. Celebrities like Adele, Miley Cyrus, and Ryan Reynolds have opened up about their personal experiences with depression and anxiety. The song “I Am Not Okay” by Jelly Roll is a chart-topping hit. Millennials and Gen Zers (and maybe even some Gen Xers) have really started talking about these important topics. (Note: I consider myself to be part of the “Xennial” microgeneration and have noted this shift firsthand over the course of my medical career.)

As a psychiatrist, I’m thrilled that these topics are getting more attention and public awareness. Your mental health has so much impact on your personal and professional life. Of course, saving for retirement, paying off your debts, and spending intentionally are extremely important, but one of the best investments you can make in the longevity of your career and in protecting your assets is to shore up your mental (and physical) health.

In my professional work, I’ve had the privilege of helping my patients to attain better mental health. In my personal life, I’ve had to figure out ways to help myself stay healthy and avoid burnout.

None of what is discussed here should be eye-opening news, as we all generally know what we should do to optimally care for ourselves. The hard part for many physicians and other healthcare professionals is finding the time and motivation to implement healthy habits amidst so many other people, tasks, and obligations competing for our attention.

Lifestyle Matters

There are no shortcuts to supporting your well-being. It’s an ongoing process across a lifetime that requires continued attention. As medical professionals, we hopefully know what we should be doing to maintain our health.

In my clinical work, I do a lot of lifestyle counseling and short-term goal-setting with patients, and I have seen it pay off. I also try my hardest to practice what I preach. I know there are no workarounds to getting enough sleep, eating a wholesome and nutrient-rich diet, doing regular physical activity, and getting enough social engagement. It’s even better when I can combine more than one of these areas.

Here are some strategies I’ve implemented in each of these areas in my own life and in helping my patients. I like to think of these four areas as the pillars upon which to build your own wellness model.

Physical Activity

I started working out regularly when my children were young, and I have kept it up with a lot of consistency, effort, and intention. At first, I exercised after work, but after realizing how much time that took up at the end of the day when I wanted to relax with my family, I became a (reluctant) morning workout person, waking up at 5:45am three days a week.

I framed it in my mind as not being a choice but a necessity. I found something that worked for me and kept me accountable to myself—group exercise classes with a coach. I know I’ll work harder around others than if I’m on my own, and I like the aspect of not having to think about my workout and just do whatever the coach instructs. (On a side note, as many did, I purchased a pandemic Peloton bike which I still use. But I prefer the in-person classes.) About six months in, I even got my husband to join the same gym, and we try to get workouts in together when we can. Through the years, we’ve also built up a friend community at our gym which has been an added benefit. Now, more than 1,500 workouts in, the positives continue to reinforce themselves.

This is just what worked for me, but there are countless other options (hiking, biking, running, joining a rec team). If you had the dedication and work ethic to make it through medical training, board exams, etc., then starting an exercise regimen is totally doable (even if you have to wake up at the crack of dawn). If it seems too overwhelming, picking one area to focus on and setting a short-term goal (baby step) can help. One example: just going for a short walk in the evening provides a foundation on which to build. Even better if you go with a friend or family member, so you can knock out exercise and social engagement together. I sometimes walk with my neighbor at night which gives us time to catch up, be outdoors, and get in some extra activity. The benefits of physical activity on mental and physical health are indisputable.

More information here:

Getting Rich and Ripped: How WCI Principles Help Build Wealth and Improve Your Physical Fitness

Sleep

There are an infinite number of distractions competing for our downtime—electronics, social media, the latest Netflix show, and more. I often have patients who stay up late (and still have to get up early) because it’s the only quiet time they have in their day, and I totally understand that. But it impacts them whether or not they admit it. I’ve had patients many times tell me they can get by on five or six hours of sleep and be just fine. The truth is that adults need a minimum of seven hours of sleep per night on average.  Getting below that amount on a regular basis is linked to all sorts of well-documented increased mental and physical health risks.

My sleep quality has decreased as I’ve gotten older, so I have to be even more intentional with my habits. I also fall into the traps that many of us do, like scrolling on my phone before bedtime. I try to read instead. I go to sleep earlier than I ever thought I would (the early morning workouts eventually caught up with me). My children tease me that I can barely make it through a show or movie without dozing off if it’s after a certain time. I can see, though, that I have better energy and focus when I’ve had a good night of rest.

Many of you know the basics of sleep hygiene: a consistent bedtime, a comfortable/cool environment, and minimal ambient lights and sounds. You also should limit caffeine late in the day, avoid naps, have a wind-down routine, unplug from electronics, and get natural light exposure during the day. Bypassing these is not a viable option if you want to get quality sleep. I’ve even convinced my night-owl husband to go to sleep earlier and (gasp!) he feels more energy during the day. (Now if I could just get him to stop drinking caffeine at night . . .).

If you do only one thing from this list, aim for seven-plus hours of sleep. There is no way to get around that.

Nutrition

As someone who enjoys cooking, I try to make home-cooked, wholesome meals for my family as much as I can. Yes, we still resort to packaged or frozen meals when we are pressed for time, but I’ve worked hard to make this the exception.

I try to keep ingredients for most of our favorite meals on hand, and I have a binder with family-favorite recipes that is easily accessible. I’ve found that stocking lots of fresh fruits and vegetables naturally adds to our recipes. My husband has taken to meal planning, making a list of all the dinners we will have that week and keeping a running list of meal ideas. Both of these strategies have helped us to feed our family better than we would have otherwise. I’ve more recently been trying to make multiple batches of something and freeze another 1-2 meals for later.

The benefits of good nutrition are sometimes harder to appreciate in the short term, but hopefully, they will have a positive impact on our mental and physical health in the longer term. (But don’t sweat it if you have to feed yourself or your family fast food or similar on those hectic days; we all do sometimes.)

Engagement

As cliché as it sounds, the high points in life are really about experiences and social relationships. It’s hard to fit in extra activities on top of a busy physician work and home life. As my children have gotten older, I realized it was imperative to invest in these areas as well. One of the screening questions I ask with my new patients is about hobbies and activities. Sometimes, patients tell me what things they wished they had time for or about things they enjoyed in their youth. If you need a place to start, that is often a way to find something that piques your interest. I sought out things that were convenient, like an adult tennis class that occurred at the same time and place as my son’s class. I had not picked up a racquet in many years, and I was never a serious player. But I met new friends and gained a whole new hobby that I love. And again, this one hits multiple wellness pillars.

I joke with my kids about all of my hobbies by saying, “I’m practicing for retirement.” But I’m also doing something important by modeling enjoyment as an adult and prioritizing time with friends. Some of the hobbies I’ve developed include a social aspect like a weekly tennis group, book club, and Mah-jong group that I’ve joined. But some are solitary like reading, cooking, baking, and crafting. I like to describe myself as an extroverted introvert. I love socializing with friends and family but also enjoy my “quiet alone me-time,” as my kids call it. I went as far as to invent something called my “quiet zone,” which is a euphemistic way to tell my husband I just want to be left alone for some downtime.

We all fall somewhere on the introversion-extroversion scale, but I find that a mix of both types of activities works best for me. I even put myself out there and registered on a whim for a hip-hop dance class at my daughter’s dance school last year. I have virtually no dance experience, but it turned out to be a group of women around my age having a blast learning routines (and likely looking ridiculous). I can see how having these regular activities to look forward to has gotten me through some difficult times and strengthened my ability to cope with stress in a healthy way—especially since there has been a heavier focus on loneliness and its effects on health (even raising the risk for dementia).

I’ve tried to prioritize my relationships with my family and friends, but this takes intention and effort as well. Last year, after over five years of talking about it, I finally went on a much-needed ladies' weekend with two of my medical school classmates. It was restorative to just be together, enjoy each other’s company, and truly get some reprieve from the busyness of our lives (the good food and spa did not hurt either). We’re already looking forward to the next time as soon as we can coordinate three busy physician-mom schedules again (no easy feat)!

More information here:

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Action Plan

There is plenty more than can be written about these wellness pillars and a myriad of ways to strengthen and weave them into our lives. If you’re already doing these things, great (you must be superhuman)! For the rest of us, a good place to start is to pick one pillar and a single action item. Write it down, schedule it, or tell an accountability partner. Once that is established, build on it or pick another aspect to work on. And talk about your mental wellness ideas and challenges with friends and colleagues. The fact that taking care of your mental well-being has become a part of the cultural zeitgeist has helped to legitimize these conversations more.

I know what it’s like to be in a two-parent working household, raising younger or older kids and taking care of a home all at once. I also know that if I don’t allow myself to take some time for enjoyment, I will not be at my best for my loved ones or my patients. Whether you are single or coupled, early or late career, or have kids or not, the same principles apply. Picking something from each of the four wellness pillars is a great way to empower yourself on your wellness journey.

What do you think? What strategies do you use to keep your mental health in check? Know somebody who could use this information? Make sure to share it with them.

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