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Care for Your Physical Health

Having poor overall health can make recovery harder. Finding ways to take care of your health can aid your recovery and help you feel better. Get routine check-ups and visit your doctor when you're not feeling well. Sometimes, it is hard to tell whether not feeling well is due to a side-effect of your medicine,  a symptom of your mental illness or a different health problem. Your doctor can sort it out. Once you have practiced living healthy you should make a list of things that work for you to stay healthy; for instance walk my neighbor's dog, eat more apples and get enough sleep. It is also a good idea to make a list of things that you know from experience trigger unhappy moods and make symptoms worse. Making a list of the ways to live well and triggers to avoid will help you live the healthiest life possible and avoid some unnecessary health (mental and physical) complications. Some websites (like SparkPeople and Just Keep Moving) and smart phone applications offer free calorie counters, workout trackers, and personalized diet and fitness plans. They can be a great resource to learn about stretches, healthy eating, and being active. They also allow you to track your progress and see how you are doing in reaching your goals. Eat Right Be Active and Exercise Get Enough Rest Avoid Smoking and Drugs Manage Stress Avoid Negative Self Talk Get the Care You Need

Eat Right

Sometimes, medicine can cause you to gain weight. Other times, eating unhealthy foods can cause weight gain. Foods high in calories and saturated or "bad" fats can raise your blood pressure and cholesterol. This can increase your chances of gaining weight and having other health problems, like heart disease and diabetes.

No one knows exactly which foods promote maximum mental health. But following some basic suggestions can boost your energy, mood and overall wellness:

Consider the new food pyramid: The U.S. Department of Agriculture, which builds the food pyramid, says a healthy diet.

• Emphasizes whole grains found in bread, crackers, rice, or pasta;
• Includes a variety of fruit and vegetables, encouraging dark green and orange vegetables, dry beans, and peas;
• Includes getting calcium (often from milk);
• Chooses lean or low-fat meats and poultry, adding a variety of fish, beans, peas, nuts, and seeds.

For additional nutritional information, see mypyramid.gov. You'll find a food tracker, menu planner and other tools.

• Don't skip meals. Eating consistently throughout the day provides your brain and body with a steady supply of fuel. It also prevents your blood sugar from dropping, which can cause nervousness, irritability, and other problems.
• Snack well. Sustain your energy by eating healthy snacks. Try to eat some nuts, whole or dried fruit or other portable food.
• Work on your balance. Maybe you know that your body needs a varied diet. But have you thought about your brain? Your brain needs a healthy supply of carbohydrates, fats, and proteins, or it can't perform functions that affect your mood and thinking.
• Don't over-diet. Eat to be healthy and fit - not to compare to anyone else. Strict food rules usually backfire, and excessive dieting can be dangerous. If you or someone you know seems at risk of an eating disorder, professional counseling can help.

Talk to your doctor to learn more about how to have a healthy diet.

Diet and Depression

Some evidence links depression and nutrition, although some of the research is still under debate. Nutrients that may play a role in combating depression include:

• Vitamin B-12 and folate. Good sources of B-12 are fish like salmon and trout and breakfast cereals that indicate in the nutrition information that they are fortified. Folate is found in dark leafy vegetables, almonds, dairy products, and fortified whole-grain breakfast cereals. Examples of fortified food include milk, salt, and certain cereals such as Special K, Cheerios, Total, Wheaties, and Kellogg's Frosted Flakes.
• Omega-3 fatty acids. The best source of omega-3 fatty acids are fatty fish like salmon, catfish, and trout. Other sources include ground flaxseeds, walnuts, and egg yolks.

If you're feeling depressed, diet alone is likely not the answer. Consider contacting a mental health professional to get help.

Be Active and Exercise

Along with a healthy diet, exercise can improve your health and well-being. Exercising regularly can increase your self-esteem and confidence; reduce your feelings of stress, anxiety, and depression; improve your sleep; and help you maintain a healthy weight. Living with a mental health condition can lead to isolation and loneliness. Getting active is the antidote.    

While the object is to start getting active, it's good to start gradually. When you are not well, a small amount activity can tax your energy and concentration, so it is important to pace yourself to start with. Talk with your mental health provider about how much activity to take on. Don't be hard on yourself if you can't do all that you hoped to at first. You will gain stamina and strength with time and practice.

There are lots of ways to start getting more active. Go to the library or get out to the mall. Pursue your favorite hobby or take one up. Go to a musical event; while some cost money, others are free. Check for free or low-cost activities at public recreation centers, parks and adult education programs. If there is a tuition charge or admission fee, there may be discounts for people with disabilities or seniors.

For your overall health, the American Heart Association recommends:

• At least 30 minutes of moderate aerobic activity (think walking or a leisurely bike ride) five days a week PLUS strength training twice a week.

OR

• At least 20 minutes of vigorous aerobic activity (like jogging or a challenging bike ride) three days a week PLUS strength training twice a week.

The Centers for Disease Control offers more detailed guidelines.

Find a type of exercise that you enjoy and talk to your doctor. You might enjoy walking, jogging, or even dancing. You don't have to go to a gym or spend money to exercise. Some suggestions include:

• Check out your local community center for free, fun activities.
• Take a short walk around the block with family, friends, or coworkers.
• Take the stairs instead of the elevator. First making sure the stairs are well lit.
• Turn on some music and dance. Dance along to your favorite television shows.
• Exercise to a workout video (public libraries offer a great variety and are free) or even a Wii fitness game.

Inexpensive suggestions to improve strength training include:

• Do squats, push-ups, lunges, crunches, leg raises, or the plank in your home.
• Participate in community classes of Pilates, yoga, or other types of exercise that focuses on strengthening your core abdominal muscles.

Getting regular exercise is important. Especially if you have been inactive, it's OK to start gradually. It's a good idea to discuss your exercise plans with your doctor, especially if you have health conditions or are older.

However you choose to get active, it's always better if you can get a friend to join you or find a friendly place for your activity. Look for adult education classes, activities where you worship, community centers, and senior centers. Local newspapers and their websites often feature weekly calendars of upcoming events.

Get Enough Rest

Sleep can affect your mood as well as your body and is important to your recovery. Not getting the right amount of sleep can make day-to-day functioning and recovery harder. For tips on how to sleep better, contact the National Sleep Foundation at 202-347-3471 or visit the World Sleep Foundation blog.

According to the National Institute of Mental Health Epidemiological Catchment Area study, "the risk of developing new major depression was much higher...compared to those without insomnia". Furthermore in their study of about 8,000 participants, 40% of those with insomnia and 46.5% of those with hypersomnia (sleeping too much) had a mental illness. The relationship between getting enough rest and reducing the risk of depression, anxiety, and other mental illnesses is strong.   

Nearly two-thirds of Americans say they lose sleep because of stress. That's especially unfortunate because sleep combats some of the fallout of stress, and poor sleep has been linked to significant problems, including:

• Greater risk of depression and anxiety
• Increased risk of heart disease and cancer
• Impaired memory
• Reduced immune system functioning
• Weight gain
• Greater likelihood of accidents

Tips for Improving Your Sleep

To sleep longer - and better - consider these suggestions:

• Set a regular bedtime. Your body craves consistency, plus you're more likely to get enough sleep if you schedule rest like your other important tasks.
• De-caffeinate yourself. Drinking caffeine to stay awake during the day can keep you up at night. Try resisting coffee and sodas starting at six to eight hours before bed.
• De-stress yourself. Relax by taking a hot bath, meditating, or envisioning a soothing scene while lying in bed. Turn off daytime worries by finishing any next-day preparations about an hour before bed.
• Exercise. Working out can improve sleep in lots of ways, including relieving muscle tension. Don't work out right before bed, though, since exercise may make you more alert. If you like, try gentle upper-body stretches to help transition into sleep.
• Make your bed a sleep haven. No paying bills or writing reports in bed. Also, if you can't fall asleep after 15 minutes you can try some soothing music, but if you remain alert experts recommend getting up until you feel more tired.

Avoid Smoking and Drugs

Substance Use

If you find yourself drinking or using drugs to cope, it is time to seek help. Although using drugs and alcohol may seem to help you cope, substance use can make your symptoms worse, delay your treatment and complicate recovery. It can also cause abuse or addiction problems. To find help now, call 800-662-HELP or visit http://www.findtreatment.samhsa.gov/.

Substance abuse affects an estimated 25 million Americans. When accounting for the people who are affected indirectly such as families of abusers and those injured or killed by intoxicated drivers, an additional 40 million people are affected.

There are many symptoms and warning signs of substance abuse including:

• Using the substance on a regular basis (daily, weekends or in binges)
• Tolerance for the substance
• Failed attempts to stop using the substance
• Physical and/or psychological dependence
• Withdrawal symptoms (delirium tremens, trembling, hallucinations, sweating and high blood pressure)
• In some cases dementia

Treatment of substance abuse is geared towards abstinence and includes a variety of therapies. Psychotherapy aids patients in understanding behavior and motivations and in developing self-esteem and coping with stress. Self-help groups such as Alcoholics Anonymous and Dual Recovery Anonymous are very effective in helping the patient establish a support network. In some cases medications may be used with some success.

Smoking

If you smoke, talk to your doctor about quitting. Smoking puts you at risk for problems like heart disease and cancer. For more information about quitting, call 800-QUIT-NOW or visit http://www.becomeanex.org/ and http://smokefree.gov/.

If you are experiencing trouble getting motivated or need additional support visit http://www.njchoices.org/ to learn tips to quit smoking and read people's stories about being smokers and having mental health conditions.

Addictions

To read more about the dual diagnosis of addictions and mental health conditions read the section on addictions and visit Mental Health America's factsheets on co-occurring disorders.

Do you use smoking, drugs, or alcohol to cope? - Click here to access a short checklist.

Manage Stress

Everyone has stress. It is a normal part of life. You can feel stress in your body when you have too much to do or when you haven't slept well. You can also feel stress when you worry about your job, money, relationships, or a friend or family member who is ill or in crisis. Stress can make you feel run down. It can also cause your mind to race and make it hard to focus on the things you need to do. If you have a mental illness, lots of stress can make you feel worse and make it harder to function.

There has been considerable research done that proves that stress exacerbates mental health conditions. Studies indicate that work and family stress are associated with mental health conditions and loss of productivity at work and in normal day-to-day functions. One study conducted by an Australian researcher found work stress to be a significant risk factor for developing mental health conditions and decreased work productivity. To read the full study click here: http://www.ijmhs.com/content/3/1/4. Further research has been done on many specialized populations (migrant workers, army personnel, dentists, teachers, et cetera) demonstrating that stress leads to an increased likelihood of developing or worsening a mental health condition.

How do I know if I am suffering from stress?

• Each person handles stress differently. Some people actually seek out situations which may appear stressful to others. A major life decision, such as changing careers or buying a house, might be overwhelming for some people, while others may welcome the change. Some find sitting in traffic too much to tolerate, while others take it in stride. The key is determining your personal tolerance levels for stressful situations.
• Stress can cause physical, emotional, and behavioral disorders that can affect your health, vitality, and peace-of-mind, as well as personal and professional relationships. Too much stress can cause relatively minor illnesses such as insomnia, backaches, or headaches as well as such potentially life-threatening diseases as high blood pressure and heart disease.

Still unsure if you are suffering from too much stress?

Take this quiz at http://www.mentalhealthamerica.net/llw/stressquiz.html. Remember that stress can also lead to serious mental health problems, like depression and anxiety disorders.

If you are feeling stressed, there are steps you can take to feel better:

• Take one thing at a time. For people under tension or stress, an ordinary workload can sometimes seem unbearable. The best way to cope with this feeling of being overwhelmed is to take one task at a time. Pick one urgent task and work on it. Once you accomplish that task, choose the next one.
• Know your limits. Let others know them too. If you're overwhelmed at home or work, or with friends, learn how to say "no." It may be hard at first, so practice saying "no" with the people you trust most.
• Practice stress reduction techniques. There are a lot of things you can do to make your life more peaceful and calm. Do something you enjoy, exercise, connect with others or meditate.
• Know your triggers. What causes stress in your life? If you know where stress is coming from, you will be able to manage it better.
• Talk to someone. You don't have to deal with stress on your own. Talking to a trusted friend, family member, support group or counselor can make you feel better. They also may help you figure out how to better manage stress in your life.
• Shed the "superman/woman" urge. No one is perfect, so don't expect perfection from yourself or others. Ask yourself, "What really needs to be done? How much can I do? Is the deadline realistic? What adjustments can I make?" Don't hesitate to ask for help if you need it.

Avoid Negative Self Talk

Negative thinking can often drag you and others around you down. There are many different types of negative thinking and you may not even realize that you are doing it. It is an important part of living well to overcome and change the negative thinking. Some ways of overcoming the negative thinking include replacing the negative thought with a positive one, repeating positive statements, and seeking professional therapy from a cognitive-behavioral therapist. Common types of negative thinking are:

Magnification and Minimization - this is placing a bigger importance on the negative events while ignoring the positive ones. When you start thinking in always, never, everyone, nobody, et cetera, then you are thinking too much about the negatives and using those to over-generalize. This is also called "all or nothing" thinking. An example of this would be: I always embarrass myself, nobody likes me.

Emotional Reasoning - this is drawing conclusions based on emotions and ignoring the facts. An example of this would be: I am angry with you so you must be wrong and the source of my problems.

Should Statements - this is relying on the absoluteness of "should" statements. "Should" statements cause the thinker to create rigid rules for themselves and others that need to be followed without flexibility. An example of this would be: I should always avoid talking about my personal issues with others. Or even: I should always wear black shoes after Labor Day.

Labeling and Mislabeling - this is the constant applying of labels on people. Often the labels are inaccurate or negative as you never know all the information. An example of this would be: She is promiscuous because she flirts a lot. Or even: He must be an alcoholic because he has had three glasses of beer to drink.

Personalization - this is blaming yourself for things you do not have control over, causing unnecessary stress. This could be thinking that it is your fault that the train came late or that it is your fault that your teenager likes suggestive rap music. An example of this would be: I am the reason that my insurance denied payment for medication.

If you find yourself caught in the loop of negative thinking, sit down and identify three strengths or things you do well. For instance you could be a good listener, in good physical shape, good with animals, or remember names easily. 

Get the Care You Need

Get routine check-ups and visit your doctor when you're not feeling well. It may be due to your medicine or a symptom of your mental illness. But it could also be a different health problem. Create a Family Health Portrait of the diseases and illnesses your family has faced and take it to your doctor to discuss your risks and what you should be looking out for.

Of course you don't have to be in crisis to seek help. Why wait until you're really in pain? Even if you're not sure you'd benefit from help, it can't hurt to explore the possibility.