Addressing The Four Pillars of Health to Improve Mental Health
When I was at university, studying my Bachelor of Health Science in Naturopathy, the first subject I ever did was about Naturopathic Philosophy and Principles.
One of the first things I ever learnt was the principle of “treating the underlying cause of disease.” 7 years later, everything I do in my clinical practice is fundamentally guided by this key principle.
Being in clinical practice has really shown me the importance of approaching health and disease by addressing/treating the underlying causes, as this is where we get the best results. When we treat underlying causes of health issues we don’t have to go chasing after individual symptoms
The majority of health issues that present to me in the clinic are chronic diseases/health issues relating to hormonal disruption, cardiovascular disease, digestive issues, chronic infections, food allergies and intolerances, skin issues, weight loss and mental health issues (mainly anxiety and depression).
Chronic disease is steadily on the rise in our modern society. Due to advances in modern medicine, people are much less likely to die from acute infections or trauma. Nowadays, chronic diseases are cutting our life short and also affecting the quality of our lives due to their debilitating symptoms.
What is interesting is that a lot of research is starting to show that the underlying causes of these chronic health issues are poor diet and lifestyle habits that are well within our control such as lack of sleep, lack of exercise, poor diet choices, smoking, excess alcohol consumption, chronic stress and decreased mental/emotional health. Adhering to a healthy diet and lifestyle, along with the advances of modern medicine, we should be living long and healthy lives, with a good quality of life in old age.
As mentioned, these chronic diseases are severely affecting our quality of life and yet we can control a majority of the underlying causes and exacerbating factors. This is evident to me in clinical practice because 99% of the time when people see me in clinic, no matter what the chronic health issue is, they have inconsistencies around their diet and lifestyle habits, which is ultimately driving their health issues.
The reason why poor diet and lifestyle factors underlay chronic diseases/chronic health issues is because they increase inflammation in the body. Most chronic diseases and their symptoms are ultimately driven in some shape or form by chronic inflammation.
Our diet and lifestyle habits play an important role in regulating our inflammatory status in our body. Good diet and lifestyle habits decrease inflammation and keep disease at bay, as well as slow disease progression. Poor diet and lifestyle habits on the other hand increase inflammation and depending on your genes, it will determine how the inflammation manifests.
Our genes are said to load the gun, but our environment pulls the trigger. Disease causing genetic predispositions can be turned on or off depending on our diet and lifestyle. Good habits turn off genes and bad habits turn on genes. Therefore, a family history of a certain disease does not mean you will certainly get that disease, however you are at an increased risk if your diet and lifestyle is poor.
Because diet and lifestyle habits play such an important role in chronic disease development and progression, the majority of my work in clinical practice is based around helping people, through habit-based coaching, to make practical and sustainable changes to their diet and lifestyle habits. This is to ensure their new habits last long after our face to face consults.
Diet and lifestyle habit change is much harder than taking a supplement or medication, so it is important to do it in a sustainable, achievable and practical way that doesn’t overwhelm the person, leading to long lasting change. This is why I try not to overwhelm my patients and I drip feed them new habits each consult, which increases the likelihood of them implementing them.
I want to empower my patients with the correct information so that they can take control of their own health, instead of relying on me for help. Changing diet and lifestyle habits to increase well being is not a 6 weeks challenge or an “all or nothing” approach. It is about making the right choices, most of the time, even when we don’t necessarily feel like it. Of course we will slip up from time to time and that is ok. Because in the context of our lives, a few slip ups here and there, in the backdrop of a solid foundation, doesn’t matter at all.
Commitment to making good diet and lifestyle choices should last a lifetime. They are consistent choices we make on a day to day basis. They are not something that we start on a Monday and if we slip up once, everything is ruined. Like I said, it is not ‘all or nothing.’
So how does this all relate to anxiety and depression?
Like all chronic health issues, anxiety and depression have some element of inflammation driving it. People with anxiety and depression have increased inflammatory signaling in their brain, which disrupts normal physiological functions around mood.
This is no surprise to me because in clinic, most people who have mental health issues have inconsistencies around their diet and lifestyle habits. This drives inflammation in their body, which can contribute to both their mental and physical health issues that they are seeking my help for.
Physical ailments and their effects on a person’s quality of life can cause anxiety and depression, therefore improving physical ailments by treating underlying inflammation, via diet and lifestyle change, will improve a person’s quality of life and therefore their mental health. However, most of the people I see in clinic have depression and anxiety for other reasons, driven by external and internal causes, and their physical health issues/symptoms effect on their quality of life is merely just an exacerbating factor.
In this post, I will focus most of my discussion around how addressing diet and lifestyle factors can help in the treatment of anxiety and depression, by decreasing inflammation in the brain and body, therefore improving mental health symptoms. Diet and lifestyle change is often overlooked in the treatment of anxiety and depression and should be done alongside medication and psychotherapy. Medication, as well as herbal/nutritional supplementation are likely to be much more effective in treating mental health issues in the backdrop of diet and lifestyle changes, which are addressing all of the multifaceted underlying causes.
Mental health issues are driven by a complex interaction between our genes, diet, lifestyle and environment, which is why a single pill will never be a cure. We need to address all of the underlying causes.
When changing a person’s diet and lifestyle habits, it is important to work on all the habits together because they all affect one another. An inconsistency in one of them will have an effect on the other habits. For example, if someone has poor sleeping habits and routines, which causes them to not get enough sleep and poor-quality sleep, this will affect their other habits. When we don’t sleep well, we are more likely to crave sugary foods for an energy hit, we make poorer decisions around our food and we are less likely to have the energy, as well as the motivation to cook healthy meals. We usually pick the most convenient option, which is usually not the healthiest. If we are fatigued from not getting enough sleep, we are also less likely to exercise and we also don’t handle stress as well, which can in turn lead to stress eating of unhealthy/sugary foods. Increased stress can also increase the intake of relaxant substances like alcohol or cigarettes.
Furthermore, what I’ve observed in clinical is that once people feel physically healthier after changing simple diet and lifestyle habits, they start to have more energy, lose weight and feel better about themselves. They start to feel more robust and stronger to tackle their mental/emotional wellbeing. Feeling run down and fatigued doesn’t put you in right mindset to tackle emotional issues.
Lastly, focusing on diet and lifestyle change also gives people a sense of purpose and a new journey to embark on. This can be very helpful in the treatment of things like depression and anxiety, which can be exacerbated by feelings of lacking purpose. Let’s take a look at how adjusting diet, sleep, exercise and stress management habits can dramatically improve mental health.
Diet and nutrition is one of the most hotly debated topics in the health and nutrition industry. There is a lot of misinformation and conflicting information in the media, which makes it really hard for the general consumer to know what good information and bad information is.
The media often overcomplicates nutrition. There is also a large disconnect between what research actually says and what the media reports because at the end of the day, hype driven headlines is what sells.
When you look at nutrition research as a whole, nutrition can actually be somewhat simple. Research consistently shows that people who eat more wholefoods, which is a mix of animal and plant-based foods, that are home cooked, tend to be healthier than those who don’t. They also have lower chronic disease risk.
Most of the choices we make around our food are based on cost, taste and convenience, therefore it is no wonder our diets are so poor. This is because processed, unhealthy food is usually tasty, convenient and cost effective. We do this because we are so busy and time poor, putting our health and wellbeing toward the bottom of our priority list.
All of us know we need to eat to survive, however many of us don’t really pay close attention to what we put in our mouths; therefore, we eat what is readily available. Simply educating people about healthy eating in a practical manner makes them more aware of their food choices and gives them a template in their head of how they should be approaching every meal. It gives them an understanding of what a wholefood, balanced meal should look like. Making people more conscious of their food choices, automatically improves their diet.
Eating a healthy and balanced diet (i.e. mix of animal-based protein and plants-based foods), helps in the treatment of anxiety and depression because it increases the intake of nutrients that:
– Support healthy brain function. Certain nutrients in wholefoods are essential to the production of chemicals in our brains that balance our mood, make us feel happy and decrease stress levels.
– Decrease inflammation. Certain nutrients in wholefoods are antioxidants and anti-inflammatory therefore helping decrease inflammation in our brains, which can help with treating depression.
– Support the composition of bacteria that live in our digestive systems. Our gut is lined with billions of bacteria. In the gut, there is both good and bad bacteria. The good keep the bad in check. When the good overrun the bad, due to poor diet and lifestyle habits, they release proinflammatory molecules that cause inflammation in the gut and also seep into the bloodstream and cause inflammation in the brain, which can exacerbate mental health issues.
This is why digestive disorders like IBS, celiac disease, Cohn’s and ulcerative colitis, which are characterized by gut inflammation, are associated with mental health issues as well.
The link between the gut and brain is called the gut brain axis. It is also why pre/probiotic supplementation is useful in the treatment of anxiety and depression, as well as digestive disorders because they usually go hand in hand.
We all know exercise is beneficial for our overall health, both physically and mentally. Studies show it is more effective than antidepressants in treating episodes of depression and anxiety, which shows how it can have a profound effect on our moods, mental health and emotional wellbeing. There are various ways in which exercise can benefit our mental health and help in treatment of anxiety and depression.
– Exercise releases happy chemicals in our brains like endorphins that elevate our mood and make us feel good.
– Exercise helps release stressful energy, which is important because we know stress can be a driving factor behind anxiety and depression
– Exercise helps decrease inflammation in the body. When I speak to my patients about engaging in a regular exercise regime that they enjoy, I often urge them to engage in exercise that is outdoors and in nature where possible, as well as with other people. This is because we know that getting into nature and social connection is vital to our emotional health and mental wellbeing.
Sleep is absolutely vital for our health and wellbeing. It is often overlooked in terms of its importance for the treatment and prevention of chronic disease, such as mental health issues.
It is a time where the body repairs and regenerates from a day of physical and mental stressors. If we don’t get enough sleep or enough good quality sleep, this ultimately decreases the repair of the body and leads to chronic inflammation, which can contribute to and exacerbate many chronic diseases, including mental health issues. This is why poor sleeping habits, lack of sleep and lack of quality sleep is associated with many different kinds of chronic diseases.
75% of Australians don’t get enough sleep and enough good quality sleep on a nightly basis. Based on sleep’s connection to our health and wellbeing, this is probably a large reason behind our chronic disease epidemic.
As mentioned above, there are five main factors decreasing peoples’ amount of sleep and quality of their sleep in our modern world. These are:
– Increased intake of alcohol at night and stimulants during the day like coffee and other types of caffeinated drinks.
– Increased stress levels
– Increased exposure to artificial/blue light at night (e.g. TV, phones, computers, etc)
– Noisy and/or hot sleeping environments
– Inconsistent bedtimes and wake up times
Through various mechanisms, these five factors disrupt the main hormones that govern our sleep and wake cycle called our circadian rhythm. Ultimately, they cause decreased production of melatonin at night, which is our main sleepy hormone. Melatonin is the main hormone responsible for our ability to fall asleep, stay asleep and the beneficial effects of sleep, as it is a potent anti-oxidant. It is responsible for the repair and regeneration of the body at night.
Therefore, decreased melatonin production at night can have a profound effect on our sleep onset, sleep maintenance and sleep quality. Sometimes we may fall asleep and stay asleep but wake up feeling groggy in the morning. This may be because melatonin has not been released in optimal amounts, leading to a poor quality sleep.
Simple changes around these five factors can make a huge difference to our sleep onset, maintenance and quality. People often say to me in private practice that they are insomniacs, but once we remove technology, decrease stimulants, create a consistent sleep routine and have a good wind down routine to decrease stress levels at night, all of a sudden they fall asleep quicker, stay asleep and wake up feeling refreshed! This can have a significant impact on their quality of life and when we have a good night’s sleep, we feel better equipped to deal with our emotional issues and handle our stressors.
Small amounts of acute stressors are normal and also necessary for good health. For example, exercise is a physical stressor on the body. When we exercise, no matter what we do, there is always some amount of stress put on our cardiovascular system, our bones, muscles, tendons, ligaments and our nervous system. The more intense the type of exercise, the higher the stress placed on the body.
After exercise, when we are at rest, the body repairs itself and physiological changes are put in place to help the body adapt for the next session. This is why the more we do a certain exercise, the better we get and the easier it feels. The repair process after exercise is also what leads to the beneficial effects of exercise on the body.
However, too much of any good thing, such as exercise, can be detrimental. This is because it can place too much stress on the body, overwhelming the body’s ability to adapt. This leads to fatigue and injury.
As a society, many people these days face high levels of consistent physical and mental stressors, which overwhelms the body’s ability to cope.
Stress can be both physical and emotional. Physical stressors are things like smoking, alcohol consumption, poor diet choices, lack of sleep and lack of exercise. Emotional stressors are driven by our internal responses to things that occur in our external environment. How we respond to our environment is highly dependent on our genes and all of our past experiences, especially in childhood. Therefore, to one person a situation may be perceived as stressful, while to another person it may not.
Chronic stress and poor emotional health is a large driving factor behind mental health issues. It can contribute in a number of ways.
– Stress increases the secretion of cortisol from our adrenal glands, which overtime, affects brain function, predisposing it to mood disturbances.
– Stress often throws out our diet, sleep and exercise habits.
– Stress can increase the intake of things like alcohol, drugs and cigarettes to help people numb or cope with their emotions. This increases inflammation in the body and prevents people from dealing with their underlying emotional issues.
– Stress decreases absorption of nutrients in the gut that are needed for brain health.
– Stress disrupts the gut microflora, which in turn affects mental health via the gut-brain axis.
When I talk to my patients about implementing stress reduction techniques to help with mental health issues, we often discuss the importance of regularly making time for things like:
spending time in nature and the sun
play and fun (e.g. pets, friends, family)
social connection (e.g. friends, family, romantic relationships)
finding a flow state
This is because we know these things help decrease stress levels, increase feelings of joy/happiness, improve emotional wellbeing, mitigate the effects of stress and increase a person’s ability to cope with stress.
While these are extremely valuable, I believe that increased stress and increased perceived stressors from our environment, is usually a symptom of a deeper cause that needs to be addressed. This underlying cause has something to do with our value system.
What we choose to value affects our thoughts, behaviours and emotions. Our modern society at the moment is not conducive to the formation of values that support good mental health. Bad and unhealthy values lead to chronic stress, decreased emotional wellbeing as well as the increased perception of environmental experiences being stressful.
Our values may be a reason as to why we are so unhappy as a society, despite life being better than ever from a material point of view.
Humans are hardwired to seek out connection, love and belonging. We live in a society that tells us to value and derive our self-worth from things like:
– what others think/say about us
– comparing ourselves to others
– social status
– money/material goods
– social media followers/likes/appearance
We are led to believe that only once we have these things in arbitrary amounts, we are worthy of love, connection and belonging. Reality is that none of these things, no matter how much we have of them, will ever make us feel enough. Feelings of worthiness and the belief that we are enough comes from a self-belief within. It is not defined by external things. The constant pursuit of these things in order to feel “enough,” validated, or worthy of love, belonging and connection, leaves us susceptible to mental health diseases.