By Ellen Vora, M.D.
In honor of Mental Health Awareness Month, I’d love to shed some light on the fact that you are in control of your mental well-being. We’ve been taught that mental health conditions are a genetic chemical imbalance and therefore destiny, but it’s simply not so. Often, it’s all those little decisions we make throughout the day that have the biggest cumulative impact. As a holistic psychiatrist, I can confidently say that the ways you eat, move, and think are far bigger determinants of your mental health than your genes.
Here are 20 steps you can take to empower yourself and elevate your mental wellness.
6:30 a.m. / Open the blinds as soon as you wake up.
When it comes to mental health, sleep is everything. And when it comes to sleep, circadian rhythm is everything. What cues your circadian rhythm? Light. By opening the blinds and getting bright light into your eyes early in the morning, this sets the clock on your circadian rhythm so you can feel energetic during the day and tired at night.
7 a.m. / Make sure a tall glass of filtered water is the first thing you consume.
Apart from sleep, digestive health is probably the biggest determinant of mental health. In order to have good digestive health, you need to start the day with a stellar bowel movement. By drinking a tall glass of water before you eat or drink anything else, and then resting calmly for a few minutes, you’ll encourage a good BM first thing in the morning. Filtered or spring water is worthwhile because our municipal tap water can contain pesticides, chlorine, fluoride, and pharmaceutical residue.
7:15 a.m. / Own a Squatty Potty and use it.
Buy your Squatty Potty now. And then when your glass of water cues your morning BM, use your Squatty Potty to create proper anatomical alignment. This will allow for easier and more complete evacuation, which can improve IBS, chronic constipation, chronic diarrhea, hemorrhoids, and in turn, all mental health conditions.
8 a.m. / Practice equanimity and nonreactivity.
Let’s say you’re on your morning commute and you’re stuck in traffic, or you got cut off, or you can’t find parking, or the train is running late…commuting is one of the more stressful things we do as modern human people. We can’t change those stressors (short of working from home or having a walking commute), but we can change the way we perceive and react to those stressors. We are all so conditioned to be reactive, going from zero to 60 with frustration and road rage. Instead, play around with keeping a state of equanimity and nonreactivity in the face of super-annoying stressors. Try taking a deep breath and seeing some humor in the situation. Remind yourself to tread peacefully on the earth.
8:30 a.m. / Rethink caffeine.
I don’t make any friends with this one, but it’s important, so we’re gonna talk about it. Caffeine is an anxiogenic drug, meaning it causes anxiety. If my private practice is any indication, about 200 percent of New Yorkers struggle with anxiety! We need to take a hard look at our caffeine habits and recognize their connection to our anxiety, insomnia, depression, and other mental health issues. If you’re addicted to caffeine, consider gradually reducing your overall caffeine consumption and pushing it earlier in the day, stopping by 11 a.m. or 12 p.m. Make changes super slowly, or you’ll be headachy, irritable, and tired. Caffeine is a real drug with real withdrawal. Love the ritual? Keep the ritual, and switch to decaf.
8:30 a.m. to 11:30 a.m. / Protect your morning hours for deep work.
I believe humans want to work hard, make a contribution, and enrich the world. So why does it seem like all we ever want to do is scope out the snack cart and surf social media like zombies? The problem is we’re bad at scheduling our days to set ourselves up for deep work. I find most people get into a deep flow state with work in the morning hours, approximately 8:30 a.m. to 12 p.m. If you have meetings scheduled during that time, or you open up social media, or you go down an internet rabbit hole, or your flow-state gets disrupted by the one million dings, pings, and requests from colleagues, then those flow hours will go toward doing a reeeaallygood job of responding to your colleague or doing a reeaaally good job going down an Instagram rabbit hole. But they won’t go toward deep work and creating something great. Protect those morning hours. Turn off notifications and direct your attention and energy to the important work you want to accomplish.
12 p.m. / Reach for real food.
It’s lunch o’clock, and everywhere around you are the smells of pad thai and pizza. If you want to set yourself up for optimal mental health, it’s worth making a few counter-mainstream food choices. Rather than indulging in what’s cheap, convenient, and addictive, it serves us to reach for real food. This can become a slippery slope toward obsessive clean eating, so I want to caution you that the most important dimension to this is simply that it be real food. This doesn’t mean just eating chia seeds and kale. It means eating well-sourced, pastured meats, including red meat, wild fish, carbohydrates from starchy vegetables (e.g., potatoes, plantains, sweet potatoes) instead of refined carbohydrates, plenty of veggies, plentiful healthy fats (e.g., grass-fed ghee, coconut oil, avocado oil, fatty cuts of pastured meats), and eating fruit when you’re craving sweets.
I’m not going to lie—this is expensive, it takes preparation, and it requires withdrawing from our various food addictions (usually gluten, dairy, sugar, and processed foods). But for many of us who are walking around inflamed and nutrient deficient, this is the key to mental health.
2:30 p.m. / Coconut oil on a spoon.
I know this is a weird one, but bear with me. As modern human people, we are all on a blood sugar roller coaster. This is because our diet is built on a foundation of sugar, refined carbs, milkshakes disguised as coffee drinks, and rosé. Our blood sugar spikes, then crashes, and that crash causes a host of seeming mental health symptoms, from anxiety and panic to depression and ADHD. The definitive solution is to transition your diet to a blood-sugar-stabilizing real food diet. Short of that, you can also use this as a hack: Take a spoonful of coconut oil (or almond butter, or a handful of almonds) at regular intervals throughout the day. Try to do this an hour or two before your regularly scheduled hanger crashes, like 3 p.m. and 5 p.m.
3 p.m. / Take a better break.
When you reach that 3 p.m. slump and you cannot/will not focus on mentally demanding work anymore, take a better-quality break. Most of us are conditioned to open up Instagram or Facebook and passively scroll. This is not genuinely restful or restorative, it’s just addictive, and it contributes to anxiety and depression. Instead, walk outside the building for three minutes to feel some fresh air or sunshine, do 10 jumping jacks in the bathroom, do a breathing exercise, meditate, take a nap, or talk to somebody funny or nice. All of these will be more genuinely restful, and you’ll be able to resume your work with a fresh perspective.
6 p.m. / Rethink your commute.
For most of you, this may be certifiably impossible. But for some, can you rethink your commute home? Rather than driving or taking the train home, can you walk or bike? Even if you work far from home, can you take a 60- or 90-minute walk home? I know that may seem crazy, but if you really do the math, your commute takes time, going to the gym takes time (or doesn’t happen at all), so why not combine your commute and exercise into one pleasant walk or bike ride? Bonus points for listening to an audiobook or podcast or calling your mother!
8 p.m. / Microcize.
There’s no better antidepressant than exercise. And yet, so many of us don’t do it. It’s hard to find time and energy to drag ourselves to the gym. My solution? Do five to 20 minutes of movement that you enjoy in your living room at night. After I get my daughter to sleep and before I eat dinner, I do about five to 10 minutes of Pilates, or follow along with a Zumba video on YouTube, or I belly dance, or I just put on goofy music and dance. It’s not as good as a 90-minute yoga class, but the best kind of exercise is the kind you actually do. This approach is realistic and sustainable. Try it tonight.
8:30 p.m. / Instead of TV, try this.
Many of us default to watching TV in the evening. While we’re in an era of really brilliant TV, you want to take at least a few nights off per week to do something better with your time. Read a book, call a friend, exercise, have a candlelit carpet picnic with your partner or roommate. Get vulnerable and get into a serious conversation with your partner. Have a silent disco with your roommate. In general, bring consciousness to how you use your time, and do the activities that actually enrich your life.
9 p.m. / Shut it down.
Have a time when you actually shut down electronics. Remember we opened our blinds in the morning to program our circadian rhythm? Now it’s time to tell our brains it’s nighttime. The most important way to do this is to experience authentic darkness and avoid blue-spectrum light after sunset. Screens of every nature, from your phone or laptop to watching Netflix in bed, are a strong circadian-rhythm-disrupting signal. The earlier you can shut it down, the better. This also allows your mind to unwind before bedtime, which sets you up for an easier time falling asleep and deeper sleep.
9 p.m. / Kiss your phone good-night.
One of the best things you can do for your sleep and overall mental well-being is get the phone out of the bedroom. When we keep it on our bedside table, it’s the last thing we look at before bed and the first thing we look at when we wake up. In the morning, it sets the wrong tone for the day, and at night, it sends a shock of blue spectrum light to your brain, jacking up your circadian rhythm. Set up your charger outside the bedroom, adjust your settings so you would still hear emergency calls. Your sleep will be so much better without the intrusion of dings and pings and the option to check your phone one last time to see what stressful nonsense came through at midnight.
9:15 p.m. / But wait, that was my alarm clock?!
Ah, yes. Your phone was your alarm clock. Little known fact: There’s a little known website called Amazon.com where you can purchase a physical alarm clock for about $10. Do it now! If you snooze, get a digital one that will allow you to set two alarms—one for the time you absolutely need to wake up, and one for about 10 to 15 minutes earlier. If you don’t snooze, go for a full analog alarm clock to get any unnecessary light out of the bedroom.
9:30 p.m. / Take an Epsom salt bath by candlelight.
Magnesium is a critical mineral for optimal mental health. Most of us are deficient in it. An Epsom salt bath is a great way to relax your muscles and absorb magnesium through your skin. Bonus points for using candles as your light source, which further supports a healthy circadian rhythm by convincing your brain it’s nighttime. Even more extra credit if you add a couple of drops of a relaxing essential oil such as lavender.
9:45 p.m. / Pop a magnesium supplement.
Whether or not you took an Epsom salt bath, it’s still a good idea to supplement with magnesium glycinate at bedtime. Most of us are deficient, and this can help with sleep, anxiety, migraines, headaches, constipation, menstrual cramps, muscle tension, and cardiovascular health. Take about 400 to 600 mg at bedtime. If you develop loose stool, reduce your dose.
9:45 p.m. / Write down your worries.
Studies show that the simple act of writing down with pencil and paper anything that’s still on your mind right before bed will help you sleep. It’s as though you’re outsourcing the act of remembering that list of to-do’s to the paper, which allows your mind to relax. If you find that you’re lying in bed keeping track of the 10 things you need to remember to do tomorrow, then take a moment to scribble them on paper.
9:50 p.m. / Read a paper book in bed.
If you’re used to watching Game of Thrones on an iPad in bed, this will seem perhaps a bit too wholesome. But reading a paper book in bed by the light of a dim lamp, such as a salt lamp, is a great way to put your brain in a sleep-inducing trance state. It’s also good for enriching your inner life. Give it a try. If you absolutely must read a backlit Kindle, then spring for a pair of amber plastic glasses, and wear those while you’re reading; they’ll block the circadian-rhythm-disrupting blue spectrum light.
10 p.m. / Lights out.
10 p.m.?! That’s practically dinnertime. I’m sorry, I don’t make the rules. Evolution basically made the rules. Our bodies want to fall asleep approximately three hours after sunset. And if we stay up later than that, we get “overtired,” which is the state most of us are in when we’re trying to fall asleep—tired but wired, anxious, thoughts racing, tossing and turning, and pushing against the stress hormone cortisol that got released into our bloodstream when we didn’t fall asleep at 10 p.m. One of the most effective ways to solve your insomnia is to recognize your tired signs and swoop yourself to bed right then, before you get overtired. You’ll find it easier to fall asleep and stay asleep through the night.
2 a.m. / Can’t sleep? Coconut oil.
Did you just wake up in the middle of the night? I got you. Let’s assume this is a blood sugar crash until proved otherwise. Take a spoonful of coconut oil and a sip of water, then attempt to fall back asleep. You can even keep a jar of coconut oil in the spot on your bedside table that has now been vacated by your phone! Try not to let your eyes “see” any light, because this can disrupt your circadian rhythm. If you have to shuffle to the bathroom, do your best to keep your eyes squinty and mostly closed. Avoid flicking on the light. If you need a light source, try an orange LED night light in the bathroom. When you get back in bed, take a few deep diaphragmatic breaths. If you’re struggling to fall asleep, do progressive muscle relaxation, where you tense and then release your muscles, starting at your feet and moving up to your head.