By: Michael Thomas  |  Psychiatric Nurse Practitioner at Strive Behavioral Health

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Season’s greetings everyone. Over my years of practice as a psychiatric nurse practitioner, I’ve found that the next three months can be complicated when it comes to our mental health. As Charles Dicken’s wrote one of his classic novels, “It was the best of times, it was the worst of times, . . . it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair” (Goodreads, 2020). December is often viewed as a time of happiness and joy to be spent with family, but it can also be a time of loneliness, financial stress, and heartache depending on your current life situation. Practicing in Utah, I’ve found that January and February tend to be some of the most difficult times of year for my patients due to the letdown from Christmas and the cold, dark winter weather.

With this in mind, I want to share five evidence-based self-care practices that can help prevent and treat depressive symptoms. For each of these practices, I will provide you links to videos, websites, and other resources that can help you fully engage in these valuable practices.

1. Practice Gratitude With the Three Good Things Journal

The first practice is the Three Good Things journal. This is a simple gratitude practice that was researched by Martin Seligman, a former president of the American Psychological Association, and colleagues. It involves simply taking some time at the end of the day to write down three things that went well during the day and then reflecting on why those things went well.

They found that individuals who completed the 3 Good Things Journal daily for 1 week, experienced a significant reduction in depressive symptoms and a significant increase in happiness levels. What is amazing about this practice, is these benefits were statistically significant for 6 months, with individuals who continued these practices after the 1 week study period experiencing the most benefit (Seligman et. al., 2005).

If you would like to learn more about this practice, here is a short video link: (https://www.youtube.com/watch?v=ZOGAp9dw8Ac). Here is a helpful website: (https://ggia.berkeley.edu/practice/three-good-things) and here is a video that is directed towards healthcare providers: (https://www.youtube.com/watch?v=OYMQYhey08w)

2. Get Regular Exercise

The next practice is something we’ve all heard about. It’s exercise! Regular exercise has been found to be as effective as medication for depression (Blumenthal, et al., 2007). Now, this doesn’t mean you should stop taking anti-depressants and just exercise. If you are experiencing mild to moderate depressive symptoms, regular exercise might be enough to help you manage your symptoms, but antidepressant medications are still recommended for people experiencing severe depression. Even with severe depression, regular exercise can improve depressive symptoms when combined with medications (Benson, 2011).

Here’s a link to a helpful article from the Mayo Clinic on exercise: (https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495). Some personal tips are to find something that is fun and that can make a difference if you do it for even a few minutes. To share my personal experience with this, I decided to start running in 2014 after recognizing that I was tired, out of shape, and was feeling burned out at work. Knowing my compulsive personality, I signed up for a half-marathon to motivate myself to actually run. Running a couple of miles was really rough at first and though it progressively got easier, it was still hard.

I completed that first half-marathon—though I almost fainted at the finish line—and have continued to run since then. It has helped me lose weight, but more importantly, it’s helped me manage my anxiety, improve my mood, and has changed my relationship with discomfort. There are always parts of a run that are uncomfortable, but unless you actually injure yourself, this will often go away if you keep on running. Accepting pain as a part of the experience has helped me better embrace other challenges in life. It hasn’t taken away the mental and physical pain associated with these experiences, but it has helped me accept it and continue moving forward.

3. Include Vulnerability and Self-Compassion in Your Life

The third practice I want to recommend is to include a combination of vulnerability and self-compassion in your life. For this section, I’m going to focus on the work of two different researchers. First, Brene Brown, who is well known for her research on shame and vulnerability. If you haven’t seen any of her TED Talks, I would recommend watching this: https://www.youtube.com/watch?v=_UoMXF73j0c and this: https://www.youtube.com/watch?v=psN1DORYYV0. Dr. Brown has found that being vulnerable can significantly limit the amount of shame we experience in life. This is significant because, among other negative effects, shame increases our risk for depression and suicide (Brown, 2010).

Second, Kristen Neff, who is a psychologist that initially studied self-esteem, but found that we too often compare ourselves to others in order to enhance self-esteem. This can lead to narcissism, an inability to celebrate the success of others, and having a fragile view of ourselves. Self-compassion, which consists of mindfulness, self-kindness, and universality enables us to have a more resilient self-concept and be more accepting of our struggles (Neff, 2015). Here’s a TED Talk she gave: https://www.youtube.com/watch?v=IvtZBUSplr4 and here’s a link to her website: https://self-compassion.org/

4. Focus on Your Character Strengths

Focusing on character strengths was a concept created by Martin Seligman and his colleagues many years ago. In mental health treatment, we have diagnoses that focus on what is wrong and don’t identify an individual’s strengths and abilities. Dr. Seligman and his research team identified 24 different attributes from six virtues that were present in most religious and philosophical constructs (Peterson, 2004). A questionnaire was created and validated to help people identify their personal character strengths.

While we typically focus on the character attributes we score lowest on, the recommendation with this questionnaire is to focus on your top 5 identified strengths, also called your Signature Strengths. Utilizing these signature strengths has been shown to improve both overall life and vocational satisfaction (Ovadia & Steger, 2010).

Here’s a website where you can take the free questionnaire and learn more: https://www.viacharacter.org/. Here is a short 8 minute film on this topic: https://www.youtube.com/watch?v=U3nT2KDAGOc

5. Practice Mindfulness

Last, I want to encourage you to practice mindfulness. This has been a buzzword for a few years in our society, since we tend to be so distracted! Technology has brought many wonderful improvements to our lives, but it has also brought an overwhelming amount of distraction, which has led our brains to spend most of our waking hours in a reactive, analytic mode. We are constantly thinking about past and future events, scanning our environment, and making judgments about ourselves, others, and our experiences. Mindfulness is the conscious training of our brain to be present and non-reactive. There is evidence that mindfulness can improve our mood, increase life satisfaction, and decrease psychiatric symptoms (Keng et. al., 2011).

This link has multiple guided audio and video mindfulness meditation exercises from the UC San Diego Center for Mindfulness: https://medschool.ucsd.edu/som/fmph/research/mindfulness/programs/mindfulness-programs/MBSR-programs/Pages/audio.aspx.

To summarize, I hope that at least one of these exercises seems interesting to you. I don’t expect anyone to start doing all five of them at once. I would recommend starting with whichever one seems most interesting to you. Self-care is extremely important, but it can also be hard to incorporate in our lives.

For example, I recently completed a meditation teacher training program, but still struggle to meditate regularly. I’m pretty addicted to running and crave my runs, but still often don’t get out of bed for a planned run. I actually kept a gratitude journal for about 3 months, but since that time haven’t been able to regularly do it for more than a week.

Even with all of these failures, my efforts have still been helpful. I hope that you take a similar approach to this. Be patient with yourself when you are struggling with your self-care and celebrate when you are doing well. I hope that you have a happy holiday season and challenge you to take just a little better care of yourself.

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Michael Thomas DNP, APRN, PMHNP-BC

Dr. Thomas has been a board-certified psychiatric nurse practitioner for the past eleven years. He is an associate teaching professor at Brigham Young University and maintains a part-time clinical practice where he provides transcranial magnetic stimulation, an FDA approved treatment for treatment-resistant depression, to patients at the Strive TMS clinic in Provo, Utah (http://www.strivebhc.com/about).

If you have any questions about how Blunovus can help you improve your culture and provide your employees with the emotional resources they need through our Proactive-EAP, don’t hesitate to contact us at (866) 258-6688 or go@blunovus.com.

We are here to help!

Disclaimer: Blunovus content is not therapy and is not designed to diagnose or treat any condition you may be experiencing. Please contact a medical or mental health professional for treatment that is specific to your needs.

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References:

Blumenthal, J. A., Babyak, M. A., Doraiswamy, P. M., Watkins, L., Hoffman, B. M., Barbour, K. A., Herman, S., Craighead, E., Brosse, A. L., Waugh, R., Hinderliter, A. & Sherwood, A. (2007). Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Medicine, 69(7), 587-596. doi:10.1097/PSY.0b013e318148c19a.

Brown, B. (2010). The gifts of imperfection: Let go of who you think you’re supposed to be and embrace who you are. Center City, MN: Hazelden Publishing

Duckworth, A. L., Steen, T. A. & Seligman, M. E. P. (2005). Positive psychology in clinical practice. Annual Review of Clinical Psychology, 1, 629-651. doi: 10.1146/annurev.clinpsy.1.102803.144154

Goodreads. (2020). A Tale of Two Cities quotes. https://www.goodreads.com/work/quotes/2956372-a-tale-of-two-cities

Hoffman, B. M., Babyak, M. A., Craighead, E., Sherwood, A., Doraiswamy, P. M., Coons, M. J.,Blumenthal, J. A. (2011). Exercise and pharmacotherapy in patients with major depression: One year follow-up of the SMILE study. Psychosomatic Medicine, 73(2), 127-133, doi:10.1097/PSY.0b013e31820433a5

Keng, S. L., Smoski, M. J. & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31(6), 1041-1056, doi:10.1016/j.cpr.2011.04.006.

Littman-Ovadia, H. & Steger, M. (2010). Character strengths and well-being among volunteers and employees: Toward an integrative model. The Journal of Positive Psychology, 5(6), 419-430, Doi: 10.1080/17439760.2010.516765

Neff, K. (2015). Self-compassion: The proven power of being kind to yourself. New York, NY: William Morrow Paperbacks

Peterson, C., & Seligman, M. (2004). Character strengths and virtues a handbook and classification. Washington, DC: American Psychological Association. Simmel, G. (1950). The sociology of Georg Simmel. Glencoe, IL: Free Press

Seligman, M. E. P., Steen, T. A., Park, N. & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychology, 60(5), 410-421. Doi: 10.1037/0003-066X.60.5.410