Feeling down? Go outside!

In previous discussions, we have explored simple, evidence-based interventions for battling depression including exercise (see Exercise as treatment for depression) and diet (see Dietary changes to decrease depression). This discussion will cover the benefits of spending time outside to help reduce depression.

How can spending time outside improve your mood?

There are three factors related to being outdoors and decreased rates of depression. These are sunlight exposure, increases in physical activity, and exposure to the natural environment (1).

Sunlight exposure. There is a great deal of literature indicating positive benefits of exposure to bright light (i.e., light exposure therapy LET) for depression. The benefits of light therapy as it pertains to mood are more closely linked to helping persons develop appropriate sleep-wake cycles (sleep hygiene will be covered in a future blog post) (2). It can be surmised that exposure to sunlight yields similar benefits to LET. Another benefit in exposure to sunlight is in increasing levels of vitamin D. Low levels of vitamin D is linked to depression (3). Wearing sunscreen will not impact the health benefits of sunlight exposure, so be sure to lather up!

Physical activity. Time spent outdoors is commonly associated with being active (walking, playing sports, etc.). A brief exploration of factors related to depression and exercise are explored in another blog post titled: “Exercise as treatment for depression”

As was addressed in the above-mentioned blog, physical activity is related to decreased depressive symptoms. When compared to indoor exercise, outdoor activity has increased benefits for reducing depressive symptoms (4) .

Exposure to the natural environment. Exposure to the natural environment is associated with decreased rates of depression (5). Another study found that that time spent in nature, especially around water is associated with several positive mental health effects (e.g., improved mood, decreased stress) (6). To achieve improved mental health, the minimum recommended time spent outdoors is 3 hours per week (1)

To summarize: Spending two to three hours per week outside is associated with decreased rates of depression.

So, get outside!
Be well, 😊

1. Beyer, K., Szabo, A., & Nattinger, A. (2016). Time spent outdoors, depressive symptoms, and variation by race and ethnicity. American Journal of Preventive Medicine, 51(3), 281–290.

2. Golden, R., Gaynes, B., Ekstrom, R.D., et al. (2005). The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. American Journal of Psychiatry, 162(4) 656-662.

3. Anglin, R., Samaan, Z. Walter, S., & McDonald, S. (2013). Vitamin D deficiency and depression in adults: systematic review and meta-analysis. British Journal of Psychiatry, 202(2) 100-107.

4. Mitchell, R. (2013). Is physical activity in natural environments better for mental health than physical activity in other environments? Social Science & Medicine, 91, 130–134.

5. Beyer, K, Kaltenbach, A., Szabo, A., Bogar, S., Nieto, F., & Malecki, K. (2014). Exposure to neighborhood green space and mental health: evidence from the Survey of the Health of Wisconsin. International Journal Environmental Research on Public Health, 11(3) 3453-3472.

6. Barton, J. & Pretty, J. (2010). What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environmental Science and Technology, 44(10), 3947-3955.

Exercise as treatment for depression

Given all the events in the world today including social isolation due to COVID-19, tension related to political events, and impact on financial well-being its is to be expected that many of us may struggle with feelings of being depressed. What can I do to help improve my mood and sense of well-being?

There are several non-pharmacological interventions that are helpful for treating depression including exericise, socialization, dietary changes, engagement in enjoyable activities (i.e., hobbies) and more.

I will be posting a series of blog entries on non-pharmacological (non-prescribed medications) ways of helping yourself to improve your mood. The first of the interventions to be explored is exercise.

To review my post on dietary changes to help with depression, click here: https://therapistspeaks.com/2021/01/28/dietary-changes-to-decrease-depression-2/

*It is important to note that when treating clinical depression, the interventions explored in this series of posts can be used as an adjunct to prescription treatment by a physician- not a substitute!

Exercise

According to the World Health Organization (WHO) (1) and the National Institute for Health and Care Excellence (NICE) (2), exercise is a valuable intervention for depression. For a detailed description of benefits of exercise as an intervention for depression, see Rethorst, Wipfli, Landers (2009) (3).

Two specific forms of exercise, neuromuscular exercise and endurance training have been found to be especially helpful for treating depression (4). Neuromuscular training focuses on balance, strength, coordination, and proprioception. Examples of this type of exercise are tai chi, yoga, and simple weight training. Endurance training is exercise which requires sustained levels of exertion (a.k.a. aerobic exercise). Examples of this type of exercise are brisk walking/ running, cycling, and playing active sports (e.g., soccer, tennis, and basketball).

For exercise to be effective, the American Heart Association suggests at least 2.5 hours per week (roughly three 45 minutes per week) (5).

Summary: Forty-five minutes of exercise, three times per week (endurance training or neuromuscular exercise) can be helpful for improving your mood.

Happy New Year and here’s to feeling better!

😊

WHO. Mental Health. Physical Activity. (n.d.). Available online at: http://www.who.int/mental_health/mhgap/evidence/depression/q6/en/ (Accessed December 06, 2017).
NICE Depression: The Treatmentand Management of Depressionin Adults. NICE Clinical Guidelhine 90 (2013).
Rethorst, C.D., Wipfli, B.M. & Landers, D.M. The Antidepressive Effects of Exercise. Sports Med 39, 491–511 (2009).
Nebiker, L., Lichtenstein, E., Minghetti, A., Zahner, L., Gerber, M., Faude, O., & Donath, L. (2018). Moderating effects of exercise duration and intensity in neuromuscular vs endurance exercise interventions for the treatment of depression: A meta-analytical review. Frontiers in Psychiatry, 9.
American Heart Association Recommendations for Physical Activity in Adults and Kids | American Heart Association. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

How do I choose a therapist?

A common question is “how do I find the right therapist for me”?

The term “therapist” is a universal term which covers a variety of disciplines including mental health counseling (also known as professional counseling), clinical social work, marriage and family therapy, counseling psychology, and clinical psychology. All disciplines require at least a master’s degree and more than one thousand hours of supervised clinical practice prior to licensure. All licensed mental health professionals are trained in basic competency for all mental health issues. Many therapists will also identify specialties (e.g., trauma, depression, anxiety, etc.). Selecting a therapist who specializes in your issue could help maximize the possible benefits of therapy. A specialist is particularly important for issues which may be either less common or requiring increased sensitivity such as sexual trauma, gender identity, videogame addiction, etc.

How do I select a therapist? If you have health insurance, call your provider to see who the approved in-network providers are in your area. Therapy is an investment into your well-being though can become pricey. Exploring options with the support of your insurance would be a good place to start.

Most insurance cards will have a number for “mental health”, or the like listed on the back of your member card. When you call, they will ask for a brief description of what you may need help with and then offer a list of providers in your area.

Once you obtain a list, you can do some research on each provider. Most therapists advertise on Psychology Today (www.psychologytoday.com) and provide information on their theoretical orientation, rates, services provided, and areas of specialty. Therapist may also have their own sites which contain similar information.

Some things to consider when selecting candidates to be your therapist might be gender, age, and culture/ ethnicity, and religious/ spiritual orientation of the counselor.

Ultimately, the best way to evaluate a therapist as a potential fit for you is to schedule an appointment and spend a session with them to see if you feel comfortable. Don’t be afraid to ask questions about their approach to therapy or how they may be able to help you specifically with whatever it is you would like to work on. A good working relationship with a therapist is a very valuable tool, so selecting someone who is a good fit for you will pay off in dividends.

I hope you have found this helpful! 😊

Keywords: counseling , counselor, therapy ,therapist, psychotherapy , psychotherapist , selecting a therapist , finding a therapist , mental health treatment.

COVID Thoughts 1

Hello Friend,

SO much has been happening these days and it’s hard to comprehend the scope of what we are living through.

Virtually all aspects of our lives have been impacted by COVID-19: At its worst is the growing number of deaths due to the disease. For those who keep their lives, we are now faced with reconciling the entire infrastructure of our economy and society. What will our lives outside our homes look like once the dust settles? I wonder if the café where I love to sit and write will remained closed forever. This is a very high-class problem but it’s the creature comforts that we miss…

I long for some sense of normalcy to return. I am fortunate to have suffered a severe injury last year which has left me with limited usage of my left hand. Adjusting to life with a disability involves accepting a new “normal.” I continue to grieve the loss of the use of my hand but know that staying in those thoughts for too long brings suffering. Accepting the new normal, including uncertainty of what is next, is our next task.

We humans have been very fortunate for a long time. We are now faced with something which is causing widespread damage and we don’t like it. Fair enough. In many ways, we have been spoiled as we haven’t experienced the suffering, at a very base level, that so many other species in the world have.

I feel this whole experience will be very grounding for humanity. It is giving us an opportunity to reflect upon what is truly important in life (as we have now become increasingly aware of our own mortality).

I am so excited to see (either on social media or riding bikes around my neighborhood) so many families bonding with each other. The degradation of the family unit contributes to much distress and I hope that this time with each other will invigorate bonds with one another.

I encourage- no implore you to take this time as a big “reset” to evaluate your true needs and wants and consider how to implement them in your lives.

I would love to get some audience participation on this post so please offer a reply below.

Be well. 😊

Born Under a Bad Sign

“Born under a bad sign… I’ve been down since I began to crawl” -Albert King

I have worked with a handful of clients who have concluded that bad things happen to them because of destiny, being unlucky, God hating them, being cursed, paying for transgressions from a previous life, or just simply being bad. They were easily able to provide evidence to support their position including having suffered abuse as children, experiencing premature death of loved ones, and seeming to always be the one getting into trouble (both as a child and an adult). These people were entrenched in their position and seemed to embrace and integrate it into their sense of identity. Their primary relationships were with people who had similar perceptions of themselves.

My interpretation of what they are saying is that, due to some omnipotent force beyond their control, that their life is oriented toward pain, loss, defeat, sadness, failure and ultimately suffering (or at the very least, a lack of peace, happiness, and contentment). They feel rejected by life.

This is a profound belief for a person to have of themselves.

Often, these people have not been treated with the dignity and respect that they, along with all people, deserve and thus I explicitly incorporate it into my treatment plan for them. The effective use of empathy and a consistent application of unconditional positive regard is critical. I see myself as serving as a liaison between them and humanity through offering a corrective experience with someone who cares for them. I listen to their stories and apologize for past hurts they have endured. I identify and celebrate their strengths. I offer them comfort and support. We find commonalities in our lives. We laugh. A lot.

In stark contrast to these individuals’ appraisals of themselves, I find them to be incredibly inspirational. They have endured a great deal of heartache and pain and have somehow survived. Their strength and tenacity are enviable. I am honored to be a part of their recovery/ journey.

My Counseling Philosophy

I believe that the meaning of life for all living things is to grow, thrive and when it is time, to die. All living things naturally engage in this process. For people, this process can become slowed or derailed by issues such as non-integrated trauma, messages received about self (especially during formative years), and an array of possible physiological issues (caused by genetic or environmental influences). This belief is aligned with the humanistic traditions of psychotherapy which suggest that given the appropriate environment, people will have a tendency toward self-actualization. Carl Rogers stated: “The organism has one basic tendency and striving – to actualize, maintain, and enhance the experiencing organism” (Rogers, 1951, p. 487). My beliefs inform my approach to my work with clients.

My general approach to working with clients is to build a therapeutic alliance with them while collaboratively determining what I may be able to help them with. To achieve this, I work to understand the client’s worldview and attempt to develop a sense for what it feels like to be them (or at least understand their experience within the current context of their lives). Through listening and asking questions I work to find factors which are contributing to the individual’s challenges. These factors generally include beliefs about themselves, others, or situations; dysfunctional behaviors they are engaged in (e.g., chronic drug use) or sometimes a general lack of direction (e.g., purpose in life). Very often, the predominant issue in their life is that they have no one with whom they can have honest conversations.

I believe that much can be gained through honest discourse. Through honest conversations with others, people can learn to develop meaningful relationships. I frequently act as a surrogate for others to practice talking about their inner thoughts, feelings, and desires which they can hopefully transfer to other relationships in their lives.

I try to remind myself that everyone is doing the best they can with the tools they have to work with or within the context within which they exist.

I believe that life is hard. Therefore, I try to offer comfort and support to all my clients. I am direct with my clients with my insights, but I also infuse humor (when appropriate). Laughter is important to me. I believe in laughing often. My personal hardships and experiences allow me to respectfully make light of even the worst situations.

I use self-disclosure when I feel that it could be helpful to the person or to the relationship. I try to show my humanness when I can.

I know my place. If I am meeting with a person who is 25 years old, I ask myself, what in this hour of this person’s life can I realistically expect to accomplish?

If I incorrectly approach a topic with a client, or if my speculations are erroneous, I own my mistakes. I apologize. I admit when I don’t know. This is directly related to the value that I place on relationships. If I acknowledge my mistakes, it models healthy behavior. If I admit when I don’t know, I show that I am ok with not knowing, that I don’t expect myself to know everything, etc. I apologize when I am aware that I may have overstepped a boundary or when I have said something other what is true.

Finally, I seek to inspire. I seek to challenge people’s beliefs about themselves and to consider there may be more possibilities. I want people to find peace and to experience the joys of living. Despite my sometimes-cynical personal nature, professionally, I am an idealist of sorts. I have a (Doctor Who 🙂 )poster in my office which reads: “I am and always will be the optimist. The hoper of far-flung hopes and dreamer of improbable dreams.”

Rogers, C. (1951). Client-centered therapy: Its current practice, implications and theory. London: Constable.

I hope you are well. 🙂

“I’m sorry” versus a true apology

What does it mean to say “I’m sorry” for something? It is a phrase that we are taught to say when we have done something that we have become aware is a transgression against another person. But, aside from social convention, do these words have any real value? Do these words clear the transgression?

Teaching words to a person without emphasizing meaningful change of action, which led to the transgression, is of little value (aside from social convention).

Consider what the words/ sounds “I’m sorry” mean to a dog. Like all sounds to all animals, it means nothing on its own. When pairing it with something that the dog is likely to respond to, it becomes something of value. For example, a dog owner with an anger issue kicks his dog when frustrated. After the owner settles down, he apologizes to the dog and pets it on the head. In his (the owner’s head) he has corrected the transgression and the dog is supposed to acknowledge the apology, forgive the transgression, and forget what has happened.

What might the dog have learned after years of this process? My owner gets angry and kicks me a lot. Then he pets me and says words that seem to make him feel better. I really like when he pets me, but it is only after he kicks me. I have tried to learn all the words he says so I can be a good dog. The words “I’m sorry” seem to mean something to him but to me, they are the words he says when the beatings have stopped for the time being. I must be on the lookout for when he’s angry, so he doesn’t hurt me so much. I try to be a good dog and love him, but he hurts me a lot.

How have we taught those around us what the words “I’m sorry” mean when we say them? Do they mean that we wish we hadn’t done what we did, that we ask for forgiveness, and that we will do everything within our control to ensure it won’t happen again? Or, are we just saying words when we know we messed up?

Words without substance have little value. When you use the words “I’m sorry” do your best to change the behavior to reduce risk of repeating it. If you find you are unable to do it on your own, get help.

-This article is written as a reflection to my work with people with substance use disorders. They frequently apologize for hurting those around them and continue to do the behavior which they are apologizing for. Over time, “I’m sorry” means nothing to the family of an addict. In early recovery, the words “I’m sorry” can still mean little (as it should). The behaviors indicating that a change is taking place (i.e., staying clean) have much more value than idle words.

To the angry dog owner: Stop kicking your dog- this will be a true apology.

Gratitude

Hello friend,

Welcome or welcome back to my blog! 😊

Today’s talk is on gratitude.

I choose to believe in the existence of God and thus, I pray.

In my morning prayer today, I started as I usually do by saying “Heavenly Father, thank you for this day.” And then, I stopped.

During and prior to my training as a therapist I realized that though my path to recovery included a belief in God others’ path may not. I place deep value on helping all persons. This sentiment led me to the conclusion that whatever tools I have found useful during my own spiritual journey must be made available for use without a belief in God.

So, today’s talk is on gratitude.

I was taught “give thanks!” Throughout my walk I have heard many say “thanks” but have been under the impression that they do not experience the feelings associated with gratitude. Do you?

Merriam-Webster (2019) defines gratitude as: The state of being grateful: Thankfulness.

What is “being grateful?” This source defines grateful as: 1) appreciative of benefits received; 2) Pleasing by reason of comfort supplied or discomfort alleviated.

In “giving thanks” are we merely saying the words which represent a concept or are we experiencing the state of appreciation for comfort supplied or discomfort alleviated?

To experience gratitude, it would seem that there needs to be a target to whom one directs their appreciation- for a believer, this target would be God. But, what about those who don’t believe? Can these folks also experience the sense of gratitude? I say, YES!

To return to the beginning of this writing, while thanking God for the day and the chance to be alive for yet another day I asked myself, “what if there is no God and I am just saying words?” And then, this notion of the importance of taking time to be grateful came to me. And so, I began focusing on experiencing gratitude. If there is a God, he doesn’t need a chump like me to offer a “thanks.” Instead he would want me to experience the joy that accompanies taking time to appreciate what I have (life for another day).

A non-believer can also take time to appreciate being alive for another day. He can consider all the people who have walked the Earth before him and acknowledge that now is his time and that at some point soon, it will end. She can appreciate that although things may not be great that there are inevitably good things in her life and that simply spending a few moments focusing on these things, even if it’s just the ability to draw breath, can bring some peace of mind or even joy.

So, I encourage you, whatever your beliefs, to take a moment to experience the state of appreciating what you have today.

😊

Be well,

Jim

Featured

Hello and welcome!

My name is Jim and I am a therapist, thinker, writer as well as professor of psychology.

I am excited to have an opportunity to share with you my thoughts on life, mental health, and being a therapist.

The writings contained in this blog are, unless otherwise stated, largely reflective of my personal insights, opinions and experiences. At times I will address topics which have arisen during my work with clients. Of course, as a therapist, I am bound by confidentiality and thus will not offer direct accounts or any potentially identifying information of any client. Instead, I will explore themes by either altering identifying information about a particular client or by developing hypothetical persons who may be a combination of several individuals with whom I have engaged in psychotherapy.

I welcome questions and comments though will not engage in counseling or related activities in this forum.

Thanks for stopping by and I hope you find this blog useful. 🙂

Be well,

Jim