Your Brain on Exercise

Exercise Improves Mental Health

It is likely common knowledge by now that physical exercise is good for overall health and emotional well-being, however I think it’s worth taking a slightly deeper dive into this subject, as I find that more in depth knowledge can help people to feel motivated to create new habits. Hundreds of research studies have demonstrated that the benefits of regular exercise go far beyond physical health.  Positive effects have been shown for anxiety, depression, bipolar disorder, ADHD, psychotic symptoms, suicidal ideation, insomnia, and cognitive aging. 

For example, individuals with major depressive disorder who exercise regularly may need about half the dose of antidepressants compared to those who do not exercise; for me, this evidence creates a powerful argument for psychiatrists to “prescribe” physical exercise to augment medications in patients with depression.   Physical exercise can also improve attention and executive functioning in children with ADHD, reduce anxiety in individuals with anxiety disorders, improve symptoms of psychosis in adults with psychotic disorders, and reduce the risk of developing suicidal ideation.

In non-clinical populations (individuals who do not have a mental health diagnosis), exercise can reduce symptoms of anxiety and depression as well.

How Does it Work?

We don’t know with 100% certainty exactly why exercise improves mental health, but we have a pretty good idea of at least a few likely mechanisms in the brain.  We know that when people exercise, it leads to an increase in molecules in the brain that reduce neuroinflammation, protect neurons from dying, and promote and stabilize new connections between neurons in areas of the brain that are important for regulating mood and learning.  These molecules include irisin (released by skeletal muscles during exercise), BDNF (brain derived neurotrophic factor), the same molecule that scientists believe is responsible for the effects of some antidepressants, and dopamine, a neurotransmitter responsible for motivation, learning and memory, regulating attention, and reinforcing pleasure-seeking behaviors.

I can think of very few down sides to exercise, other than mild and temporary muscle soreness, provided you are exercising in a responsible way, with guidance when needed.  The way I like to describe this to my patients who may not feel motivated to exercise, is that it is kind of like taking a medication, but without the side effects.  And yes, I do “prescribe” exercise to my patients!

How Much Exercise is Enough?

There are a range of ideas about this, and the answer really depends on the specific research study that is being quoted.  In general, following physical activity guidelines from the American Heart Association and U.S. Department of Health and Human Services is a good starting place: 150 minutes of moderate intensity aerobic exercise, or 75 minutes of vigorous aerobic activity per week for adults, and 60 minutes of moderate to vigorous physical activity per day for children and teens. 

How Will you Know if it is Working?

I would suggest identifying the specific changes you want to see in your mood and/or symptoms, and keeping track of these over time. Some people start to notice benefits within 3 weeks, and most notice improvements in their target symptoms within 12 weeks.

Your Brain on Nature

Exposure to Green Spaces Changes Your Brain!

You may have experienced the calming effects of spending time in nature, but are you aware that there is a neurobiological basis for this calming experience?  Scientists who study the structure and activity of the brain have known for some time now that spending time in nature can change the brain. 

Specifically, the part of the brain that is associated with fear, anxiety, and trauma-related disorders is less active after spending time in nature.  Moreover, the overall structural integrity of the brain is improved by living in proximity to a forested area, presumably due to spending time in that same forested area.

These findings suggest that you can reduce feelings of stress and anxiety by spending time in green spaces, whether that is a park, a forest, a botanical garden, or your backyard. 

How Does Nature Impact Mental Health?

What do we know about access to green spaces and mental health?  Recently, the entire world experienced a major stressor in the form of a global pandemic that changed the way we work, play and relate to each other.  During the pandemic, those who spent more time in nature were less likely to experience depression and anxiety, possibly due to reduced experiences of stress. 

We also know that time in nature can improve memory, attention and impulse control, both for typically developing individuals, and those with attention and impulse control challenges, such as individuals with ADHD.

The benefits of time in nature go beyond mental health as well, and include improved academic performance, improved cognition, and improved physical well-being.

How Much Nature is Enough?

Well, the more the better, however the few research studies that have tried to answer this question have shown that the most benefit from indoor green spaces is achieved when 10-25% of the space is filled with plants. 

The benefits of time in outdoor green or blue spaces can be seen after just 5 minutes, however the more time you spend in nature, and the more frequently natural spaces are visited, the more likely you are to benefit. 

I hope this knowledge motivates you to go outside, find a green (or blue) space, and enjoy the calm and clarity that comes from your time in nature.

Self-Hypnosis for Sleep: A How-to Guide

All Hypnosis is Self-Hypnosis

Hypnosis is a state of deep absorption, in which individuals lose awareness of their surroundings, and become highly suggestible. All hypnosis is self-hypnosis, meaning that individuals allow themselves to enter this trance-like state, rather than being forced to do so by someone else. When used with wisdom, the power of suggestion can be an effective means of making positive changes in peoples lives.

Everyone has experienced the state of hypnosis, although not everyone is aware that they have been in a trance-like state, and not everyone uses the terminology of hypnosis.  Some common examples of trance-like states include watching television, daydreaming, and becoming absorbed by work or play.  As you attempt to intentionally use self-hypnosis in your life, try to remember that you have done this before, many times, so you can definitely do it again.

One way in which I apply self-hypnosis in my clinical practice is for challenges surrounding falling asleep and staying asleep.  I have taught this strategy to family members, friends and patients, and I use it myself. Many of us have found it very helpful for those restless nights when sleep does not come easily, for falling asleep on overnight flights, and any other situation in which you feel you need a little extra help with sleep.

Helpful Tips:

• Please do not use self-hypnosis for sleep in any scenario during which it would be dangerous for you to fall asleep (i.e. driving, operating machinery, etc).

• You can choose to memorize this script, and recite it to yourself in your mind, or you may prefer to use a recording of your own voice.

Step 1. Prepare to Sleep:

• Prepare to sleep by finding a comfortable position, laying in your usual location for sleep (for most people, this will be in their bed).

• If you are on an airplane or train, get as comfortable as you can while sitting up.

• Decide for yourself what you’d like your sleep to do for you – do you want your sleep to be restful? Restorative? Calming? Healing?  Choose three benefits you would like to experience while you sleep, and insert these into the following script where the letters are in bold.

Step 2. Self-Hypnosis for Sleep Script:

 1. Say to yourself (in your mind, not out loud): 

“I will count down from 10 to 1, and as I count down from 10 to 1, I will become progressively more relaxed, letting go of all of the tension in my body, letting go of all of the unnecessary thoughts in my mind….becoming so relaxed, and so tired, that by the time I reach the number 1, I will fall into a deep, restful, restorative sleep”.

2. Pause for several seconds.

3. Then say to yourself:

“10…starting to relax now, letting go of all of the tension in my body, letting go of all of the unnecessary thoughts in my mind…becoming so relaxed, and so tired, that by the time I reach the number 1, I will fall into a deep, restful, restorative sleep”

4. Pause for several seconds.

5. Then say to yourself:

“9… feeling more relaxed now, letting go of all of the unnecessary tension in my body, letting go of all of the unnecessary thoughts in my mind… …becoming so relaxed, and so tired, that by the time I reach the number 1, I will fall into a deep, restful, restorative sleep”

6. Pause.

7. Then say to yourself:

“8…. feeling even more relaxed now, more and more relaxed, letting go of all of the unnecessary tension in my body, letting go all of the unnecessary thoughts in my mind… …becoming so relaxed, and so tired, that by the time I reach the number 1, I will fall into a deep, restful, restorative sleep”

8. Continue to repeat this script for numbers 7 through 1… if you are still awake after you reach the number 1, then repeat the entire script.

In my experience, I usually fall asleep by the time I reach the number 6…

I hope you find this helpful, and may you enjoy your deep, restful, and restorative sleep…