Lifestyle Tips to Ease Your Anxiety and Improve your Mental Health

If you find yourself in a frequent state of excessive uneasiness or apprehension, you may be experiencing an anxiety disorder. Often anxiety is felt emotionally—like feeling dread, overwhelmed or panicked, but occasionally these emotions are accompanied with physiologically symptoms like breathlessness, heart racing, sweating, chest pain or discomfort. If these sensations sound familiar to you, know that you are not be alone. Anxiety disorders are one of the most common mental illness in the United States and affects nearly 1 in 5 people at any given time.  

Freud believed anxiety reflected inner emotional conflict, but now we have a more biologic understanding of anxiety. Research demonstrates that anxiety results from the interplay of many factors including genetics, diet, environmental exposures, chronic illnesses and social and emotional well-being.  If we want to quiet the anxiety in our mind, we need an approach that supports each of these factors. 

Consider the following lifestyle tips for addressing anxiety:

START HERE

1. Eat an anti-inflammatory diet. Our mental health is an extension of our overall health. If our body is inflamed or deficient in nutrients, then your mental health will suffer. Food is the most important environmental factor when it comes to repairing your brain and keeping your body healthy. Eating well is an act of radical self-love. It unfortunately doesn’t come cheap, and often requires immense effort, but if you’re looking for the keys to the kingdom of feeling good, then look right in front of you on your plate.

   An anti-inflammatory diet focuses on nutrient-dense, unprocessed, whole, real food. It includes an abundance of vegetables; well-sourced meat, fish, and poultry, fermented foods, nuts and seeds; fruit; and plenty of healthy fats such as olive oil, avocado, coconut oil, and fatty fish. What is not present is sugar, refined carbs (i.e., bread, crackers, pasta, cookies, even seemingly healthy vegan or gluten-free replacement foods), and inflammatory oils, such as canola oil.

   Research from the new and exciting field of nutritional psychiatry is demonstrating the power of food to influence our mood. Check out these great resources for more details:

   • This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More by Uma Naidoo

   • Brain Changer: The Good Mental Health Diet by Felice Jacka

   • Eat to beat Depression and Anxiety: Nourish Your Way to Better Mental Health in Six Weeks by Drew Ramsey

2. Actively manage stress. Our response to stress is regulated by a complex set of interactions between two parts of our brain—the hypothalamus and the pituitary glands and the adrenal glands. This subsystem of the body is often called the HPA axis. It is responsible for triggering the release of hormones needed to respond to stress. In pathologic anxiety, this HPA axis may become dysregulated. The normal cues to turn off the production of stress hormones are missed, and you may be left feeling stressed despite the threat being gone. Taking proactive steps to manage stress can help keep the HPA axis healthy. Activities like meditation and yoga are well documented to help relieve anxiety and depression. These not your cup of tea? Try other reflective practices like journaling, making music or even coloring mandalas. The trick is to find a practice that resonates and make it happen. Check out these resources to get started:

   • Relaxation apps: Headspace, Calm, The Tapping solution, Heartmath

   • The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel Van Der Kolk

3. Prioritize sleep. Lack of sleep activates the stress circuit and inhibits our relaxation. Our modern life often keeps us up and plugged into our devices much later than we should be. The circadian rhythm of the human body works best when we fall asleep approximately three hours after sunset and wake with the sunrise. Try going to bed by 10 pm every night. Avoid blue light emitted from devices that can suppress your production of sleep promoting melatonin. Exposure yourself to bright light in the morning by opening the curtains, going for a walk or sitting with a lightbox. Check out these resources to get started:

   • Lightbox from Amazon

   • Blue light blocking glasses from Amazon

   • Why We Sleep: Unlocking the Power of Sleep and Dreams by Matthew Walker

4. Exercise regularly. Exercise alone is a powerful tool to treat anxiety. In as little as 10 days it can make a dramatic difference. The best exercise is the one you enjoy and will faithfully complete, but studies suggest that resistance training may have a slight advantage over aerobic exercise at reducing anxiety.

ADVANCED PROTOCOL

Start with the basics, but if anxiety is still problematic further evaluation and more targeted treatment may be needed. 

1. Get a medical evaluation. Imbalances of hormones (thyroid, insulin, estrogen/progesterone, etc.) blood sugar problems, nutrient deficiencies, untreated infections and toxic exposure may be contributing to your poor mood. A comprehensive discussion and laboratory evaluation with your physician are important. 

2. Monitor your Heart Rate Variability (HRV). HRV is the measure of the variation in time between each heartbeat. It is regulated by a primitive part of our nervous system called the autonomic nervous system (ANS). If a person is in a fight-or-flight mode, the variation between heartbeats is low. If one is in a more relaxed state, the variation between beats is high. The healthier our ANS the faster we can switch gears between fight-and-flight and relaxation, showing more resilience and flexibility. 

   HRV can be easily monitored and improved. There are a number of tracking devices and training apps available on the market that are specifically designed to help address anxiety. For more information check out heartmath.com, Oura ring, and Elite HRV to get started. 

3. Try tapping. Emotional freedom technique (aka tapping or psychological acupressure) is an alternative treatment for physical pain and emotional distress. It has been extensively investigated for anxiety and has been shown to dramatically improve symptoms. Similar to acupuncture, tapping focuses on the meridian points—or energy hot spots based on Chinese medicine. Tapping is easy to learn and can be completed anywhere with no side effects. Learn more here. 

4. Consider medication and/or supplements. Optimizing lifestyle is always the best place to start addressing anxiety. However, there is a place and time to add targeted supplements and medication. If the above strategies are not providing adequate relief or more urgent relief is needed, talk to your physician about making a treatment plan. 

If you’ve been feeling anxious, I hope you’re able to put some (or all) of these practices into place. I always recommend being in care with a good mental health provider to help you see your blind spots and give you support, but I’m hopeful that most people can heal their anxiety without medications and the side effects that often come with them.

If you’re experiencing depression or anxiety and need support, please call the National Depressive/Manic-Depressive Association Crisis Call Center’s 24-hour hotline at 1-800-273-8255.

Lifestyle Support for Seasonal Affective Disorder

While the pandemic has many of us feeling stressed and isolated, many of us are also confronting the long gray days of winter which may also be taking a toll on our mood. If you struggle with a low mood every winter, these strategies may make this winter a bit brighter. 

What is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder (SAD) is a mood disorder with depressive symptoms that occurs at specific times of year and fully resolves at other times of year. Most SAD occurs in the fall and winter. The cause of SAD is not fully understood, but theories implicate a shift in the circadian rhythm and alterations in serotonin in the brain as potential triggers. If you struggle with SAD, know that you are not alone. SAD affects 0.5% to 2.4% of the population at some point during their lifetime. Additionally, ten to 20% of people struggling with major depression will have a seasonal pattern consistent with SAD. 

What are the risk factors for SAD?

Evidence for risk factors is limited, but some data suggests that family history, being female, younger adulthood, and living at a more northern latitude may increase your risk.

What are the symptoms of SAD?

SAD is a subtype of major depressive disorder. Symptoms include fatigue, loss of interest or pleasure in activities, mood swings, sadness, hopelessness, and social withdrawal among others. Recent studies suggest that SAD may have additional symptoms, including excessive sleepiness, increased appetite especially carbohydrate craving, and weight gain.

How can SAD be treated?

I recommend starting with a proper diagnosis. Before starting treatment, I recommend talking with Relish Health or your trusted healthcare provider about your symptoms. Ruling out underlying physical conditions such as anemia, vitamin deficiencies, hormone imbalances or other medical conditions is important for addressing the root cause of your mood. 

Natural ways to improve SAD include:

Light box for seasonal affective disorder

1. Light Therapy, also called phototherapy, is a well-documented way to improve SAD. The therapy involves sitting a few feet from a special “light box” that exposures you to bright light within the first hour of waking each day. The recommended intensity of light is 2,500-10,000 lux. The time in front of the lamp will depend on the manufacture’s specification and your response to the light. Light boxes are about 20 times brighter than ordinary indoor light. They filter out the potentially damaging UV light, making them a safe treatment for most people. However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks. 

2. Psychotherapy, also called talk therapy or cognitive behavior therapy, is another option to treat SAD. A trained metal health professional can help you identify and change negative thoughts and behaviors that may be making you feel worse. Optimizing stress management and learning healthy ways to cope with SAD can do wonders for your mood and long-term mental health. 

3. Optimize vitamin D. Because many people with SAD often have vitamin D deficiency, nutritional supplements of vitamin D may help improve their symptoms. However, studies testing whether vitamin D is effective in SAD treatment have produced mixed findings, with some results indicating that it is as effective as light therapy but others detecting no effect.

4. Eat an anti-inflammatory diet. A nourished brain is a resilient brain. We need to consume several vitamins, minerals, fats, and antioxidants to feel our best, and the only way to authentically do that is with real food. Eat a balance of vegetables, well-sourced fish and poultry, starchy tubers (potatoes, sweet potatoes), fermented foods (sauerkraut, yogurt), nuts, seeds, fruits, and plenty of healthy fats such as olive oil, avocado, coconut oil, and fatty fish like salmon or sardines. If you think you are suffering from SAD, then avoid sugar, refined carbs (i.e., bread, crackers, pasta, cookies), and inflammatory oils, such as canola oil and see if this makes any difference in your mood.

5. Keep moving. Commit to doing something quick, free, easy, convenient, and pleasant for a least a few minutes most days of the week. Exercise is like medicine. Even small amounts can deliver antidepressant benefits. I assure you doing something—no matter how small—is so much better than nothing.

6. Medicate or supplement wisely. Because SAD, like other types of depression, is associated with disturbances in serotonin activity, antidepressant medications or targeted supplements have their place in treatment regimens. I always recommend starting with good nourishment and self-care but talk to your healthcare provider or Relish Health if additional support is needed.  

Learn more:

LIFESTYLE TIPS TO EASE YOUR ANXIETY
USE YOUR FORK TO IMPROVE YOUR FEELINGS
GOOD MOOD FOOD

References:

1. Galima SV, Vogel SR, Kowalski AW. Seasonal Affective Disorder: Common Questions and Answers. Am Fam Physician. 2020 Dec 1;102(11):668-672. PMID: 33252911.

2. Campbell PD, Miller AM, Woesner ME. Bright Light Therapy: Seasonal Affective Disorder and Beyond. Einstein J Biol Med. 2017;32:E13-E25.

3. MayoClinic.org. Seasonal affective disorder (SAD), Last accessed 2/10/2021.

4. The National Institute of Mental Health. Seasonal Affective Disorder. NIH Publication No. 20-MH-8138. Last accesses 2/10/21.

(This blog post is not sponsored by any manufacturer. However, at no expense to you, Relish Health may receive a commission on purchases made through an Amazon link.)

Lifestyle Tips to Ease Your Anxiety

If you find yourself in a frequent state of excessive uneasiness or apprehension, you may be experiencing an anxiety disorder. Often anxiety is felt emotionally—like feeling dread, overwhelmed or panicked, but occasionally these emotions are accompanied with physiologically symptoms like breathlessness, heart racing, sweating, chest pain or discomfort. If these sensations sound familiar to you, know that you are not be alone. Anxiety disorders are one of the most common mental illness in the United States and affects nearly 1 in 5 people at any given time.  

Freud believed anxiety reflected inner emotional conflict, but now we have a more biologic understanding of anxiety. Research demonstrates that anxiety results from the interplay of many factors including genetics, diet, environmental exposures, chronic illnesses and social and emotional well-being.  If we want to quiet the anxiety in our mind, we need an approach that supports each of these factors. 

Consider the following lifestyle tips for addressing anxiety:

Basics Protocol to Relieve Anxiety:

1. Eat an anti-inflammatory diet. Our mental health is an extension of our overall health. If our body is inflamed or deficient in nutrients, then your mental health will suffer. Food is the most important environmental factor when it comes to repairing your brain and keeping your body healthy. Eating well is an act of radical self-love. It unfortunately doesn’t come cheap, and often requires immense effort, but if you’re looking for the keys to the kingdom of feeling good, then look right in front of you on your plate.

   An anti-inflammatory diet focuses on nutrient-dense, unprocessed, whole, real food. It includes an abundance of vegetables; well-sourced meat, fish, and poultry, fermented foods, nuts and seeds; fruit; and plenty of healthy fats such as olive oil, avocado, coconut oil, and fatty fish. What is not present is sugar, refined carbs (i.e., bread, crackers, pasta, cookies, even seemingly healthy vegan or gluten-free replacement foods), and inflammatory oils, such as canola oil.

2. Actively manage stress. Our response to stress is regulated by a complex set of interactions between two parts of our brain—the hypothalamus and the pituitary glands and the adrenal glands. This subsystem of the body is often called the HPA axis. It is responsible for triggering the release of hormones needed to respond to stress. In pathologic anxiety, this HPA axis may become dysregulated. The normal cues to turn off the production of stress hormones are missed, and you may be left feeling stressed despite the threat being gone. Taking proactive steps to manage stress can help keep the HPA axis healthy. Activities like meditation and yoga are well documented to help relive anxiety and depression. These not your cup of tea? Try other reflective practices like journaling, making music or even coloring mandalas. The trick is to find a practice that resonates and make it happen. 

3. Prioritize sleep. Lack of sleep activates the stress circuit and inhibits our relaxation. Our modern life often keeps us up and plugged into our devices much later than we should be. The circadian rhythm of the human body works best when we fall asleep approximately three hours after sunset and wake with the sunrise. Try going to bed by 10 pm every night. Avoid blue light emitted from devices that can suppress your production of sleep promoting melatonin. Exposure yourself to bright light in the morning by opening the curtains, going for a walk or sitting with a lightbox. 

4. Exercise regularly. Exercise alone is a powerful tool to treat anxiety. In as little as 10 days it can make a dramatic difference. The best exercise is the one you enjoy and will faithfully complete, but studies suggest that resistance training may have a slight advantage over aerobic exercise at reducing anxiety.

Advanced Protocol to Reduce Anxiety:

Start with the basics, but if anxiety is still problematic further evaluation and more targeted treatment may be needed. 

1. Get a medical evaluation. Imbalances of hormones (thyroid, insulin, estrogen, etc.) blood sugar problems, nutrient deficiencies, untreated infections and toxic exposure may be contributing to your poor mood. A comprehensive discussion and laboratory evaluation with your physician are important. 

2. Monitor your Heart Rate Variability (HRV). HRV is the measure of the variation in time between each heartbeat. It is regulated by a primitive part of our nervous system called the autonomic nervous system (ANS). If a person is in a fight-or-flight mode, the variation between heartbeats is low. If one is in a more relaxed state, the variation between beats is high. The healthier our ANS the faster we can switch gears between fight-and-flight and relaxation, showing more resilience and flexibility. 

   HRV can be easily monitored and improved. There are a number of tracking devices and training apps available on the market that are specifically designed to help address anxiety. For more information check out heartmath.com and Elite HRV to get started. 

3. Try tapping. Emotional freedom technique (aka tapping or psychological acupressure) is an alternative treatment for physical pain and emotional distress. It has been extensively investigated for anxiety and has been shown to dramatically improve symptoms. Similar to acupuncture, tapping focuses on the meridian points—or energy hot spots based on Chinese medicine. Tapping is easy to learn and can be completed anywhere. Learn more here. 

4. Consider medication and/or supplements. Optimizing lifestyle is always the best place to start addressing anxiety. However, there is a place and time to add targeted supplements and medication. If the above strategies are not providing adequate relief or more urgent relief is needed, talk to your physician about making a treatment plan. 

If you’ve been feeling anxious, I hope you’re able to put some (or all) of these practices into place. I always recommend being in care with a good mental health provider to help you see your blind spots and give you support, but I’m hopeful that most people can heal their anxiety without medications and the side effects that often come with them.

If you’re experiencing depression or anxiety and need support, please call the National Depressive/Manic-Depressive Association Crisis Call Center’s 24-hour hotline at 1-800-273-8255.

Good Mood Food

Do you dread people asking you “how are you today?” Do you say “fine” but secretly you are groggy or grumpy, or maybe just feeling down or in a bad mood? Anxiety and depression symptoms are common in American adults and can affect relationships, work, and overall health. While there are common pharmaceutical and counseling solutions which are appropriate, there is an additional area that you can easily control which also is a very powerful tool affecting your mood. Let’s look at food and its impact on your brain and your mood.

Our brains are composed of some of the hungriest cells in our body. They need consistent fuel and have specific nutrient needs. Study after study  has demonstrated that eating a nutrient-dense diet that is low in sugar (like a Mediterranean style diet) can prevent and even be used to help treat depression. A diet that is rich in “good mood foods” that include B vitamins, good fats and important minerals helps boost our brain’s ability to utilize serotonin and other feel-good brain chemicals.

Here are a few key nutrients that can help lift your mood, and where to find them in foods:

Omega-3 fatty acids

Omega-3 fatty acids are essential building blocks of our brains. In fact, our brains are comprised of nearly 60% fat! EPA and DHA fatty acids found in cold water fish are the fats that help protect our brain and lower inflammation. Good sources of omega-3 fats include salmon, sardines and anchovies. (Check out these salmon and sardine recipes for inspiration.)

B Vitamins

Your brain needs B vitamins to initiate many essential chemical reactions which help prevent depression and heighten the effects of antidepressants. In particular, B12, B6 and folate are necessary for nerve cell functioning. B12 is a vitamin that predicts how fast our brain shrinks as we age. One key approach to slowing this process is to maximize our absorption of vitamin B12 by keeping our stomach and gut healthy and eating foods that concentrate B12. Sources of many B vitamins include leafy greens, whole grains, nuts and seeds and lean meat. Vitamin B12 is only found in animal products. While clams, mussels and oysters provide an especially high concentration, you can also gain benefit by eating small servings of high quality pastured eggs and meats.

Fiber and probiotics

It’s been well-established that serotonin is a powerful chemical in our brain that influences our mood. Studies suggest that 60%-90% of serotonin is in our gastrointestinal system (our gut) which makes it directly affected by our microbiome (the colony of bacteria that lives in our gut.) So, a good mood requires keeping our gut be happy and healthy. Also, the microbiome helps regulate our immunity, helps us absorb our nutrients and even creates chemicals that communicate with our brain. Fiber feeds these beneficial bacteria that are so crucial to our guts’ proper function. Probiotic foods like kefir, sauerkraut and kimchi help create and balance a proper microbiome.

Vitamin D

A lack of vitamin D is associated with low mood, but also sub-optimal immunity. The best source of natural vitamin D is sunlight absorbed through the skin. However, if you have limited exposure to light, then taking a supplement may be helpful and is commonly necessary in the Midwest. Unfortunately, natural food sources of vitamin D are limited, and include sardines and cod liver oil. Those are probably not your first choices for dinner this week. Talk to your physician or Relish Health to gain a personal assessment of your level of vitamin D to customize a solution for you. 

Roasted Salmon with Lemon Walnut Relish

Touted for its rich Omega-3 fatty acid content, salmon is an easy and frequently fast meal to bring to the table. Look for wild-caught salmon when possible for even higher omega-3 content. Adding seasonal veggies, nuts and lemon makes this recipe a deeply nourishing and tasty meal.

Roasted Salmon with Lemon Walnut Relish

Author: Erica Leazenby, MD, Adapted from Everyday Food: Great Food Fast
Serves: 4
Time: 25 minutes

Ingredients:

4 4-6 oz pieces of wild-caught salmon
¼ cup walnuts
¼ cup raisins
1 lemon, peel and juice
Hot water
3 Tablespoons olive oil
Salt and pepper
Parsley for garnish (optional)

Suggested accompaniments:

• Roasted veggies like asparagus and carrots

• Bed of spinach

• Brown rice

Directions:

1. Preheat oven to 350 degrees. Place the walnuts on a sheet pan and toast for 4-6 minutes or until the nuts are lightly toasted and fragrant. After removing the nuts from the oven place them on a clean dish towel and gently rub the nuts together to remove the skins. Remove the nuts from the towel carefully to leave the skins behind. Set aside.

2. While the nuts are toasting, peel the lemon using a vegetable peeler. Slice the peel into thin strips and place them in a small heat-proof bowl with the raisins. Pour enough hot water over the mixture to just cover the ingredients (usually ½ cup or less) and set aside. 

3. Preheat a cast iron skillet or other oven-proof pan to medium high heat. Season the salmon with salt, pepper and a thin layer of olive or avocado oil. Once the skillet is hot (a drop of water will sizzle on contact), place the salmon skin side up on the skillet. Let the fish sear for approximately 3 minutes undisturbed. Flip the salmon and place the skillet in the oven. Bake the salmon until the center is still pink yet the flesh flakes apart. This will take about 10 minutes of total cooking time per inch thickness of fish (1-inch-thick = 10 minutes total sear and bake time, 1.5-inch-thick = 15 minutes, etc.)

4. While the salmon is baking, drain the lemon and raisin mixture. To the drained mixture add the juice of the lemon, olive oil, salt, pepper and walnuts. Adjust seasoning to taste. 

5. To serve, top the salmon with a generous spoonful of the relish and a sprinkle of parsley. Enjoy. 

For a twist on this recipe, try Pomegranate Walnut Relish.

Delicious Treatment for your Mood

Our brain makes up about 2% of our body mass, but represents up to 20% of our energy need. With so much energy consumption, it has been theorized that the food and fuel we consume would affect how the brain functions which is related to how we feel at any given time. In a new study released in the journal BMC Medicine, we now have confirmation that the food on our plate plays a role in our mood.

In the study a Mediterranean diet was used to treat clinical depression.  From a set of participants with depression, researchers randomly selected two separate groups. Both groups were provided weekly social counseling to help their depression. However, the first group consumed a diet rich in whole grains, fruits and vegetables; and received weekly guidance from a dietician. The second group did not make any food modifications. After three months, researchers found that 32% of the participants that changed their diet were experiencing remission of their depression. This occurred in only 8% of the participants who had no dietary changes.

A Mediterranean-style diet has historically documented benefits for heart health and cancer prevention, and now it has shown benefit in improving our mood. Curious about how to adopt a Mediterranean diet or want advice on using lifestyle to improve your mood? Come see me at Relish Health.

If you are experiencing depression and need support, please call the National Depressive and Bipolar Support Alliance Hotline at 1-800-273-8255.