Small Victories: Mental Health
Small Victories: Mental Health
The various sections of our “Small Victories” series will focus on healthier eating, increased activity, and mental health. While these three topics are very different, they are largely connected and enjoy much crossover. Deteriorating mental health can lead to numerous physical health issues. From the Canadian Mental Health Association:
“Mental health and physical health are fundamentally linked. People living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions. Conversely, people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population. Co-existing mental and physical conditions can diminish quality of life and lead to longer illness duration and worse health outcomes.”
I’m of the opinion mental health issues arise far before they are diagnosable. While we need to be careful of labelling lifestyle choices we may not understand or agree with as mental health issues, I suspect it is quite rare for individuals to be happy or even content with deteriorating health. Even those who consciously decide they prefer eating and not restricting this practice, or avoiding physical activity, they tend to struggle emotionally and mentally with the adverse health events that arise due to their choices.
Often, by the time these consequences occur, the habits and patterns an individual has consciously allowed to form have become too set to easily break. This tragic battle wears a heavy burden, as poor health patterns continue and the added stress of guilt over the choices builds. Perhaps the added stress of the guilt leads to further poor choices, contributing to a downward spiral. This stress makes it harder and harder to make good choices, while building a rationale behind bad choices. Since “bad choices” are the new norm, our definition of bad choices and good choices shifts. Conversely, this change of expectations is also how some eating disorders progress at the other side of the spectrum.
As making “bad choices” becomes our new norm, we begin to put more weight on the odd good choice we decide to make. “I haven’t had dessert all week”, ignoring the burgers and pizza eaten, or “I had a salad for dinner”, ignoring the late-night gorge of chips, soda, or alcohol. We become desensitized to our poor choices, while putting too much weight on insignificant and isolated healthy decisions. This drives further stresses as we feel “we are putting in the effort” and “seeing no results.” Our shifting “norm” allows us to justify our struggles, ignoring the decisions that led to the struggles. It reconciles our egos comparing our situation to others, allowing us to feel “we got the raw end of the deal”. I want to make it clear that different individuals have different resting and active metabolic rates. Some do have it easier or harder, but all too often individuals will justify why they have it hard, ignoring their poor choices.
The above paragraphs represent how bad or lazy habits contribute to poor health, leading to a decrease in mental health. Conversely, poor mental health can be the causative factor leading to ill-advised decision making causing poor health, further deteriorating mental health. Many of the most common health issues, such as stress, anxiety and depression, are causatively linked to poor eating choices. They also may be linked to lower activity and poorer sleep, which we know is imperative to our health.
Stress and Eating
It is common and well accepted knowledge that stress causes poor eating choices. The fact that the term “comfort food” exists draws emphasis to this. Despite the fact that research and reviews discuss the neurological changes due to stress-associated binge eating , driving more and more compulsive behaviours,i and highly respected institutions, such as Harvard, have articles speaking about stress eating,ii there exists a tendency to judge individuals food choices, often with public shaming. It is often the predominant belief that these individuals are weak and just lazy, making bad choices, causing further stress and exacerbating the issues. While stress reduction may not always lead to better food choices, stress quite often leads to worse choices. Effectively reducing stress is an important strategy to give ourselves the best chance at reducing the risk of poor dietary decisions.Stress and Decreased Activity
Like stress and poor eating choices, most can relate to the effects of stress on cutting down motivation for physical activity. Many of the most motivated individuals will “shut down” when overloaded with stress and make choices to avoid physical activity (or other projects) for the comfort of doing nothing, watching TV or a movie. While most research on the relationship between stress and physical activity focuses on exercise’s ability to reduce stress, the research on stress’s impact on physical activity is quite conclusive.
One systematic review of 168 publications found that the majority of articles conclude that stress impairs efforts towards physical activity.iii From the systematic review, “Prospective studies investigating the effects of objective markers of stress nearly all agreed (six of seven studies) that stress has a negative effect on PA (physical activity).” It is worth noting that in 18.2% of the prospective studies, stress actually increased physical activity, likely skewed by individuals using exercise to cope with said stress. While decreasing stress for this group is still important, the impact on those who have not included copious amounts of exercise as a form of self-care can be far greater, as the ramifications lead to deteriorations in mental and physical health.
Depression and Eating
The impact of depression on eating, while clearly having an impact, is less consistent. Some turn to binge eating or make poor food choices, such as “comfort foods”, while others cannot bring themselves to prepare meals or lose their appetite, leading to malnourishment.iv I know personally, when I have been under high stress or am feeling down, I have a tendency to drift towards comfort foods. This is especially true since losing the ability to train at a high level, which was previously my most heavily relied on self-care. Different strategies work for different people regarding depression, and no advice in this area is intended to contradict or supersede advice given by your healthcare provider. Many in the natural community will vilify anti-depressants and they definitely come with varying degrees of success and side effects. That said, they save lives. For some people, perhaps small victories will help lead to more and more small victories, such as better eating choices. Perhaps this will reduce reliance on antidepressants, but it may not. If you need anti-depressants, there is no shame. Hopefully the small victories will help improve your overall health.
Depression and Decreased Activity
Like stress and physical activity, far more literature exists on exercise as a strategy to improve depressive symptomsvvi than on depressive symptoms effects on motivation to exercise. One recent study casts doubt on exercise in relieving depressive like symptoms, at least in women,vii and two recent systematic reviews contradict each other on the subject.viiiix Searches for literature on depression reducing motivation to exercise are sparse, with only passing mentions.x Despite this, major channels have articles on motivating yourself to exercise while depressed, indicating it is an issue and not my imagination.xixii
Exercise may not help with depression for everyone. That said, decreased activity and deteriorating physical health could contribute to further depression. Small steps towards staying active can prevent this and may help increase motivation to exercise, thereby potentially lowering depressive symptoms in some individuals.
Anxiety and Eating Disorders
Anxiety disorders and eating disorders are strongly correlated, perhaps causative. In fact, 2/3 of individuals with eating disorders also have anxiety disorders with 42% having developed anxiety disorders as children, well before the onset of their eating disorder.xiii Small victories may not defeat either the anxiety or eating disorders alone, but they may assist. Just like for insomnia as discussed here, cognitive-behavioural therapy has a high success rate for both anxietyxiv and eating disorders.xv
The following short articles in this series will focus on small victories to improve mental health. Different individuals may find various results for each strategy and there is no one size fits all approach. None of these strategies are recommended by us as a replacement for anti-depressants or anxiolytics, and it is essential to speak with your healthcare provider before making any changes to any prescribed medication. Next week, join us for a brief article on self-care by a guest writer.