In my last two blog posts, I considered the use of medication for the treatment of depression and/or anxiety. Cognitive Behavioral Therapy (CBT) is another tool used to treat behavioral health disorders. A third and equally important consideration in the treatment of anxiety and depression is what I call “anti-depressant activities.” I’m always careful to discuss this third element with my clients so that they can feel a sense of agency in battling their mental health issues.

Exercise is one activity that can have a profoundly beneficial impact on depression and anxiety. There is abundant data showing that 120 minutes of moderate cardio exercise per week is as effective as medication in treating these disorders. See this study conducted by the National Institute of Health (NIH).

 Note: 120 minutes can be broken into four 30-minute session of brisk walking. One doesn’t need to be running a marathon or engaging in some extreme activity to get the desired results. I would add that in dealing with my lifelong depression and anxiety generated by complex PTSD, exercise has been highly effective. In all the years and thousands of hours or working out I can think of two times when I felt physically/mentally worse after a workout and this was because I was sick and shouldn’t have been working out at all.

 Note: If you are sedentary and/or have major health issues, consult with your doctor before starting an exercise regime. Start small and increase slowly over time. Getting into shape requires building a base and this can’t be done in one day!

 The other benefit of exercise is increased self-esteem. Feeling better physically, leads to feeling better emotionally. It follows that feeling poorly physically leads to feeling poorly emotionally. Exercising regularly stimulates appetite and helps us to sleep better and feel better about ourselves.

 As we deal with depression, our tendency is to isolate. Or it may be that our anxiety makes social situations uncomfortable. Either way isolation exacerbates depression. Connection to others cuts against it. There is a difference between solitude and isolation and we have to self-reflect to determine where we are. I work with people daily and would describe myself as an introvert.

 At the end of the day I need some alone time to recharge my batteries. I would describe this as solitude with a purpose. It could tip over into isolation if I’m not careful, I may realize that I haven’t interacted with anyone for the next two days. Challenge yourself to be sure you are spending time with others. If you are socially disconnected, think about activities you like: the gym, martial arts, book clubs, cooking, hiking etc. Join with others through activities and you have started to build community.

 Evaluate your relationships to be sure they are value added. Abusive relationships will perpetuate your depression and anxiety. One client I knew described his 75/25 rule. He said he tries to maintain a 75% satisfaction level in his relationships and jobs. He understood that 25% of the time there is conflict or other difficulty in our relationships. If most of the time your satisfaction level is a high percentage, then you’re doing well. If it dips down and stays there, it may be time to move on.  

 Addictions, depression, anxiety and other mental health disorders are opportunistic diseases. When self-care is poor the conditions are exacerbated. Getting a good amount of sleep is one major key to good physical and mental health. Poor sleep makes us prone to dysregulation, difficulty concentrating, poor memory and a host of other problems. For many of us, sleep routines are poor and/or we just don’t allocate adequate time to get enough sleep. Most people have an awareness of how much sleep they need. For me, eight hours is the right amount. If I’ve worked out or had a busy work week I may try to get nine. I can survive on seven but getting below that line leads to struggles, irritability, short attention spans, anxiety and so on. Give yourself what you need, consistently!

 Another important element of consideration is being sure to maintain a work/life balance. I often ask clients if they are “working to live or living to work.” There have been times in my career when I was working on inpatient units with an intense pace and a highly emotional clientele I’d find myself exhausted on my days off with had little to offer my family. I was irritable, anxious and overwhelmed. I was just living to work.

 I have learned to pace myself better, take time off whenever I needed with the realization that my life needed more substance than just working. I learned to work to live. In other words, my job was important and required a committed effort but so did my family and personal life. In a word, balance!

 Lastly, what hobbies bring you joy? For me reading and listening to music brings distraction from my problems, inspiration and sooths my anxiety. Do you have reliable hobbies that do the same for you? If not, start to think about what things you might like to do and set aside time at least four days a week to commit to doing them.

 A checklist of antidepressant activities:

1.   Get 120 minute of moderate cardio exercise weekly. This is just as effective as antidepressant medication. (See your MD first to get clearance if you’re sedentary)

2.   Develop awareness of the difference between your need for solitude and tipping into isolation. Humans are social creatures and we need the company of others.

3.    Evaluate your relationships. Are they value added or is there too much drama and negativity involved? Employ the 75/25 rule.

4.    Maintain work/life balance. Are you living to work or working to live?

5.    Get adequate sleep. Good sleep correlates to good physical and mental health. Poor sleep the opposite.