Building Mental Health: what are your modifiable risk factors?

According to the World Health Organization, mental health is “a state of well being in which every individual realizes his or her own potential, can cope with the normal stress of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” Mental health is complex. It’s a result of the interplay between your biology, genetics, environment, experiences, and lifestyle, as well as a host of existing fixed determinants. There is no one size fits all when it comes to supporting your mental health as there are many factors that determine what is effective when it comes to psychological treatment and general support. There are also lifestyle modifications that have been shown to influence your mental health in a very significant way. This is important because in some ways, this helps gives us options to decide what factors are in our control that we can modify to effect change in our mental health.

As a psychologist, people tend to seek out my services when things are metaphorically on fire. The house is burning and they need help putting it out. There’s been only one time in the 10 plus years that I have been seeing patients, where I can recall someone called me because they wanted to act preventatively. Since everyone has a brain, why don’t we learn to take care of this thing at an early age? Why isn’t this something as natural as engaging in personal hygiene on a daily basis? I find an incredible discrepancy exists between things you can do to take care of your mental health and what the public knows about what to do about it. The science is here and it speaks for itself. Your behaviors matter. A lot. Let me give you a few examples.

 Modifiable and Non-Modifiable Risk Factors

Risk factors are defined as the factors and conditions that increase one’s risk of developing a disease. In the context of mental health, that could be the risk of someone developing Major Depressive Disorder (MDD) in the course of their lifetime. These risk factors can be either modifiable, meaning that you can technically do things to change them, or non-modifiable, which means that you cannot do anything to change them. Non modifiable risk factors include things like race and gender, while modifiable risk factors include one’s diet, and a sedentary lifestyle.

Diet

Diets higher in whole foods such as vegetables, fruits, whole grain products, beans and legumes, nuts and seeds, fish and olive oil (the Mediterranean diet), are consistently associated with a reduced risk of depression.  Did you know that lower intakes of nutrient-dense foods and higher intakes of certain foods (ultra processed foods like chips, cookies, white bread, etc.) are each independently associated with smaller left hippocampal volume? This is important because our hippocampus is responsible for memory and learning and is one of the brain structures most susceptible to harm as we age as evidenced by neurodegenerative diseases like Alzhiemer’s. These relationships are not explained by socioeconomic status, education, exercise levels, smoking, alcohol, body weight or other risk factors for heart disease which means diet alone is influencing these changes. These relationships are also found in many different countries around the world, reinforcing the idea that adhering to a mainly whole foods diet with limited consumption of ultra-processed foods is associated with better mental health outcomes.

Even more specific to simply just adhering to a healthier dietary pattern, knowing and understanding the power of certain nutrient dense foods can help you get a bigger bang for your mental health buck (if you have access to resources i.e. financial, grocery stores to purchase food, transportation to get there). For example, increased consumption of fruits and vegetables is associated with improved cognitive function and a reduced risk of age-related neurodegenerative diseases. One paper indicates a dose-response relationship in that an increment of 100 g per day of fruit and vegetable consumption was related to an approximately 13% reduction in cognitive impairment and dementia risk. For perspective, 100 g is equivalent to one medium-sized banana. Seems doable! There is even some evidence to suggest that high dose of Omega 3 fat with EPA ≥ 60% at a dosage of ≤1 g/d may have beneficial effects on depression. These findings suggest a strong correlation between our overall dietary patterns and our mental health.

Sleep

Did you know that sleep deprivation can also affect how much we worry and ruminate? One study published in 2018 reported that adults who experience more repetitive negative thoughts also experience more sleep disruptions and sleep less overall. Researchers also concluded that those who ruminate, experience worries, and are more sleep deprived, are less able to manage and focus on other kinds of thoughts other than the intrusive negative ones they experience. This is really important to understand if you are someone who experiences frequent worries and negative thoughts. If you aren’t getting enough sleep or good quality sleep, you are going to focus more on your negative thoughts and worries. Simply improving your sleep will help you think more rationally, and allow you to focus on other thoughts besides the negative ones you experience.

Stress

Stress is considered a major risk factor for poor mental health outcomes. There is a lot of different kinds of stressors that can trigger a physiological stress response in our body. While many stressors may be out of your control, working on maintaining a regular stress management practice can help feed your mental health. Did you know that chronic stress over time reduces the number of neurons in your brain and negatively affects the structure of a brain region responsible for memory and learning called the hippocampus? If you want to support and improve your mental health, prioritizing stress management is key!

 You see that I can clearly keep going. I consider these lifestyle factors as basic behavioral foundations that we can try and tweak to help support our mental health and well being. This kind of knowledge is what we should all have access to when it comes to taking care of our mental health. I want to help you understand the science behind what you can do to help support your mental health as well as help you practice these behaviors in your daily life to support your mental health and well being.

 If you want to know more or are ready to start this journey with support, check out my course Building Mental Health. It’s science and support all in one and I made it for you. It’s focused on providing you with knowledge and tools to help you build and improve your mental health using evidence based principles and science. Keeping your brain healthy is crucial to helping you live a long and healthy life. I hope you start this journey with us because your mental health is worth it!

References

 Glabska, D., Guzek, D., Greole, B., Gutkowska, K. Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review. Nutrients. 2020 Jan; 12(1): 115.

 Jacka, et al. “Western diet is associated with a smaller hippocampus: a longitudinal investigation.” BMC Med 2015; 13: 215. doi: 10.1186/s12916-015-0461-x

 Kahn M, Sheppes G, Sadeh A. Sleep and emotions: Bidirectional links and underlying mechanisms. International Journal of Psychophysiology. 2013;89(2):218–228. doi: 10.1016/j.ijpsycho.2013.05.010.

Liao, Y., Xie, B., Zhang, H. et al. Efficacy of omega-3 PUFAs in depression: A meta-analysis. Transl Psychiatry 9, 190 (2019). https://doi.org/10.1038/s41398-019-0515-5

McEwen, B. S., Nasca, C., & Gray, J. D. (2016). Stress Effects on Neuronal Structure: Hippocampus, Amygdala, and Prefrontal Cortex. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 41(1), 3–23. https://doi.org/10.1038/npp.2015.171