DEPRESSION-
7 Habits That Could Cut the Risk of Depression in Half.
A healthy lifestyle is good for your brain.

KEY POINTS-
New research makes it clear that daily habits can boost or diminish mental health.
A healthier lifestyle can ward off depression, even in those with genetic predisposition.
“We are what we repeatedly do.” —Aristotle

Your answers to these seven questions have serious implications for your mental health:
Do you get between 7 and 9 hours of sleep a night?
How much junk food do you consume?
Do you make time for friends and family?
Do you exercise regularly?
How many hours a day do you sit at your desk?
Do you smoke cigarettes?
How much alcohol do you consume?
A new study published in Nature Mental Health found that a healthy lifestyle can prevent depression, even in those who have a genetic predisposition.

While pharmaceutical advertisements have led many to believe that major depressive disorder is caused by a lack of neurotransmitters, it has become increasingly clear that depression is much more than a chemical imbalance. Remember the classic Zoloft commercial from the early 2000s showing a sad blob with a cloud following it around?

The voiceover explains: “While the cause is unknown, depression may be related to an imbalance of natural chemicals between nerve cells in the brain. Prescription Zoloft works to correct this imbalance.”

Zoloft transforms the sad blob into a smiling blob and the cloud literally dissipates. More recent evidence paints a more complicated picture that debunks this model: Antidepressant medications work for some people, but not because they correct a chemical imbalance. What remains unclear is exactly how they work.

What is clear is how daily habits can boost mental health. Researchers examined data from almost 290,000 people—of whom 13,000 had depression—over a nine-year period, and identified seven healthy lifestyle behaviors linked with a lower risk of depression:

1. Prioritize sleep. Sleeping seven to nine hours per night reduced the risk of depression including single depressive episodes and treatment-resistant depression by 22 percent. Of all the depression-reducing factors, getting a good night’s sleep on a regular basis made the biggest difference.

2. Cultivate connections. Frequent social connection reduced the risk of depression by 18 percent and was the most protective against recurrent depressive disorder. Put simply, happiness doesn’t only come from within, it also comes from “with.”

3. Drink less. Moderate alcohol consumption decreased the risk of depression by 11 percent. Less is clearly more. Greater than one drink a day for women and two drinks a day for men can actually increase the risk of depression.

4. Eat well. Refined carbs, processed foods, and sugary drinks are bad for the body and the brain. People who maintained a healthy diet were 6 percent less likely to report an episode of depression. Increasing evidence shows that the Mediterranean diet can boost mood and dial down symptoms of depression and anxiety.

5. Move regularly. Frequent exercise can improve daily mood and also cut one's risk of depression by 14 percent. A related study published in the British Journal of Sports Medicine found that physical activity was 1.5 times more effective than medication in reducing depression. Not surprisingly, the sports that give people the biggest boost typically involve others—tennis, soccer, and other team-related activities.

6. Don’t smoke. Never smoking decreased the risk of depression by 20 percent. Enough said.

7. Get up, stand up. A sedentary lifestyle was considered independent of exercise. Taking breaks and stepping away from screens regularly reduced the chances of depression by 13 percent. If you’re reading this sitting down, please stand up and stretch.

These lifestyle factors are more than icing on the cake. I would argue that they are the cake. People who maintained most of these seven healthy habits—five or more—had a 57% lower risk of depression. We all know that a healthy lifestyle is important for our physical health. It’s just as important for our mental health.

Bottom Line: While many with depression benefit from medication and therapy, lifestyle medicine can make a meaningful difference in reducing symptoms and preventing them altogether.

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Creating Boundaries to Move Through Grief.
Distraction, depression, and detachment in grief.
Reviewed by Lybi Ma

KEY POINTS-
In grief, distraction, depression, and detachment play off one another and can feel all-consuming.
A persistent inability to focus is a normal part of grief and feels different from everyday forgetfulness.
There is an opportunity to explore the self and understand more profound parts of the psyche in the dance with grief.
Maybe in another life
I could find you there
Pulled away before your time
I can't deal, it's so unfair

And it feels, and it feels like
Heaven's so far away
And it feels, yeah, it feels like
The world has grown cold
Now that you've gone away

It’s surprising at times, but grief shows up in protective ways alongside your feelings of pain and confusion. We’ve seen in previous posts the influence of our emotional armor and role confusion as we encounter yet another transition.

The whirlwind of the features of distraction, depression, and detachment is a cycle that feels all-consuming. They play off each other: distraction and detachment increase, and depression, therefore, may also intensify. Should depression rise, you may notice that distractibility and a tendency toward detaching increase in tandem.

Despite the feelings of uncertainty that characterize the three D’s, there is a real opportunity to explore the self and understand more profound parts of the psyche in the dance with grief.

There are persistent issues with focus, which is reasonable to expect in the wake of a loss. However, this mental chaos often leads to depression. Disorganization that increases in frequency may indicate that a depressive state is on the horizon.

Distraction
Losing keys now and then is part of the human experience. But maybe you’re losing track of time and possessions and generally feeling mentally chaotic or absent-minded. Feeling overwhelmed with tasks like errands and chores indicates that distraction may be part of your grief experience.

Here are some ideas for managing distractibility:
Exercise – Though it’s difficult, pushing yourself to go for a walk, even a short stroll, adds a change in scenery and releases endorphins to help you feel better and refocus. Gentle movement nurtures our physical body and supports our healing.
Sunlight – Sunlight is naturally healing and energizing. Get outside if you can, or supplement with a light therapy box.
Track negative thinking – Keep a journal to sift through your automatic negative thoughts. Externalizing your thoughts to paper or a notes app can help identify patterns and faulty interpretations, carefully challenging these thinking methods rooted in your grief.
Reach out and connect with someone – While detachment keeps you safe temporarily, connecting with others can keep you grounded and feeling validated in your grief journey.
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Depression
Grief can activate depression, an understandable piece of the grief and loss cycle. Other feelings like anxiety and anger can accompany depression and impact your ability to concentrate and engage in relationships.

Common characteristics of depression are insomnia or oversleeping, inability to focus, hopelessness, slowed thought process and memory difficulties, and thoughts of death. If depression persists for six months or more, it is a good idea to seek a professional who can walk alongside you to address your concerns.

Depression and distraction often go hand in hand and can be addressed in similar ways to push through each state of being intentional. These states are not voluntary and take work to address.

Detachment
While detachment is like numbness with a shared lack of attachment, what differentiates detachment is a choice. This choice is unlike depression and distraction, which simply are.

Detachment serves to help you set boundaries and protect your precious resources from overbearing individuals and chaos that may exist around you in the wake of loss. In addition, detachment can be developed as you emerge into a new state of being through grief.

Developing detachment, rather than fighting against it, can allow for elevated clarity as you explore your emotions and encounter safety and self-discovery.

“There is no detachment where there is no pain.” - Simone Weil

Opportunities for Healing
The cycle of distraction, depression, and detachment feels chaotic and disorienting. Still, it can be an opportunity to create a container for your pain and to develop the boundaries you need to take care of yourself. In addition, detachment can create clarity to help process emotions, memories, and thoughts while you move through the phases of grief.

EATING DISORDERS-
9 Tips for Improving the Gut–Brain Connection.
What you eat can improve your digestion and mood—and reduce disordered eating.
Reviewed by Michelle Quirk

KEY POINTS-
The gut–brain axis is a vital modulator to whole-body health, regulating emotions, cognitive functioning, digestion, and more.
The gut–brain axis is bidirectional, meaning that nutrition interventions may support recovery from mental health conditions.
Psychological interventions may help reduce symptoms in gastrointestinal and other health conditions.

With new findings regarding the gut–brain axis, we’re closer to understanding just how connected we truly are on the insides. The gut and brain communicate through the vagus nerve, which is part of the parasympathetic nervous system. This connection is known as the gut–brain axis, and it enables the two organs to receive and send signals to each other. This communication helps regulate emotions, cognitive functioning, digestion, and other bodily functions.

While the gut–brain connection means that proper nutrition may result in substantial improvements to mental as well as physical health, disturbances to either side of the axis may contribute to problems. Both eating disorders and anxiety produce physiological imbalances that alter the amount and composition of gut microbiota, the microorganisms that live in the gut.

There are many ways to positively modulate this relationship. Here are nine tips to improve your gut–brain connection and support a healthier way of living.

1. Eat a variety of foods.
Eating a wide variety of plant-based foods (such as vegetables, whole grains, fruits, legumes, and nuts), along with regular consumption of fish, poultry, and dairy products, increases microbial diversity in the gut while providing a range of nutrients (such as omega fatty acids and antioxidants) that improve overall brain health. Research shows that foods typically consumed by those living in the Mediterranean region are especially beneficial to the gut microbiota and the brain. In particular, fruits and vegetables contain a group of compounds called polyphenols, which may decrease inflammation and offer neuroprotective benefits. When it comes to protein, studies demonstrate that adequate protein consumption promotes an abundance of good bacteria in the gut while reducing pathogen numbers. Amino acids, which are the building blocks of protein, play an important role in the production of neurotransmitters such as GABA, serotonin, dopamine, and norepinephrine, all of which are essential for brain function.

2. Take probiotics.
Recent studies indicate that patients with anorexia nervosa, bulimia nervosa, binge-eating disorder, or anxiety show an imbalance in gut microbiota, which help with immune and metabolic functioning and weight regulation. When they become imbalanced, our immune system response isn’t as strong and we experience inflammation, which can be a precursor to disease. Fortunately, probiotics can help. These live microorganisms are comparable to the good bacteria found naturally in the stomach. Probiotics may help with better digestion, vitamin generation, improved motility and cognitive function, and reduced inflammation. Ask a licensed dietitian for specific recommendations.

3. Improve your mental health.
Research suggests that the gut–brain axis is bidirectional. This means that nutrition interventions may support recovery from mental health conditions, and psychological interventions may help reduce symptoms in gastrointestinal and other health conditions. Neurons and neurotransmitters are found in both the brain and gut, so feelings of happiness or anxiety, for example, could be triggered through the gut.

4. Treat IBS.
There’s a high correlation between irritable bowel syndrome (IBS) and anxiety. In some studies, participants with anxiety showed lower microbial richness. The thinking, then, is by improving the health of the gut, we also improve mental health (and lessen IBS symptoms). Interestingly, antidepressants may also help reduce some of the symptoms of IBS; a study of adolescents with newly diagnosed IBS found that the antidepressant amitriptyline significantly reduced symptoms and increased overall quality of life.

5. Reconnect and experience a sense of safety.
Stress impacts the gut barrier and gut microbiota, while trauma can have a negative impact on eating habits and the gut itself. For example, there is good evidence that individuals who have experienced trauma are more vulnerable to binge-eating disorder. Additionally, research shows that an individual who experienced early traumatic experiences may be more vulnerable to changes in the composition of their microbiome and the nervous system:

Long-lasting immune consequences and [an] increase [in] the risk of developing stress-related disorders later in life. –Leclercq, et al.

6. Meditate.
Meditation is often used as part of treatment for eating disorders, anxiety, and other mental health conditions. But new research shows added promise for meditation’s potential positive impact on the gut–brain axis, by altering the composition of the gut microbiome. A study of 37 male Tibetan monks and control subjects concluded that

The specific microbiota enriched in monks was associated with a reduced risk of anxiety, depression and cardiovascular disease and could enhance immune function. Overall, these results suggest that meditation plays a positive role in psychosomatic conditions and well-being. –Sun et al.

7. Rule out viral and bacterial infection.
Viral or bacterial infections may precede the onset of stomach problems, including the onset of eating disorders. The infections and response from your immune system can lead to associated changes such as intestinal inflammation, intestinal permeability, appetite dysregulation, and decreased richness of gut microbiota. It is possible that adaptations in the gut may be physiologically helpful when healing from infection. However, when intestinal gut microbiota responses persist after the pathogen is no longer present, there may be an elevated risk of developing an eating disorder.

8. Get educated.
Being educated about the science of good bacteria in the gut may enhance your motivation to eat more intentionally and help you to apply changes that will be effective. When you are equipped with the truth, misleading advertisements and fad diets may be less able to convince you that dieting, restricting your food intake, avoiding certain foods, or purging has no impact on your health. Knowledge can empower you to turn what you learn into practice.

9. Stay hopeful.
By making your eating more intentional, you can impact your gut biome. And, with bidirectional influences, you can improve your gut with emotional well-being and improve how you feel by increasing the richness of your gut microbiota. To make a concerted effort in improving your gut health and mood, reach out to professionals—dietitians, therapists, meditation instructors, and medical doctors—who are familiar with the gut–brain research.

The significant connection between feeling good and the well-being of your gut microbiota offers new paths for health, healthy eating, and eating disorder recovery. Being intentional about what you take into your body and your mind can have powerful whole-body effects, so nourish both with care.

Body Image and Social Media.
Why some social platforms can create the “perfect storm” for young people.
Reviewed by Davia Sills

KEY POINTS-
Young people have long been bombarded with messages and images focusing on appearance and status.
Highly visual and quantifiable social media platforms can amplify the negative impact of these messages.
Developmental changes during adolescence make youth especially vulnerable to body image concerns.
Just deleting specific apps won't solve the problem. Teens need us to engage them in conversation and action.

Being bombarded with messages and images focusing on appearance and status is not new to this generation of young people. Indeed, decades of research demonstrate that exposure to narrow beauty standards is correlated with body image concerns (this includes how young people think about their physical appearance, including bodies, faces, hair, eyes, etc.). Whether through print, TV, or advertisements, the reality is that girls, in particular, have long been bombarded with messages and images convincing them that the most important thing about their identities is their physical appearance.

Just because it's been a longstanding toxic trend doesn't mean that we should throw up our hands and surrender with, "This is just the way things are." Indeed, the design attributes of specific social media platforms like Instagram can exacerbate upward social comparisons. Dr. Sophia Choukas-Bradley, who studies gender and adolescent mental health, notes that overall time on social media, in general, is not consistently connected to body image issues. But we see a much stronger relationship when we zoom in on upward social comparison in highly visual media.

Apps like Instagram may present specific challenges because they are:
Highly visual: Many people, especially celebrities and influencers, carefully curate their images on highly visual social platforms and even manipulate images to adhere to light skin, straight hair, thin (or muscular), able-bodied, and wealthy beauty standards.
Quantifiable: Young people don't have to imagine how popular someone or something is; they can see it for themselves in likes and shares.
These attributes make it difficult for any of us to resist the urge to engage in social comparison online. But early adolescence is a uniquely vulnerable time when it comes to social media and body image. Adolescents are going through specific developmental changes, including:

Physical changes: Changes in body size and weight. For most kids, this makes them less like the beauty standards pushed by social media.
Social changes: Teens are much more susceptible to peer opinion.
Cognitive changes: The capacity to think in abstract ways includes the ability to consider "imaginary audiences."
Identity changes: Social comparison is a natural process, but as young people explore their own identities and start to answer the question, "Who am I?" social comparison goes into overdrive.

The costs of being camera-ready.
The challenge is that platforms like Instagram weren't designed with these developmental strengths and vulnerabilities in mind. They were designed for clicks, shares, scrolls, and sales. They were also designed so that a young person's photo could be shared widely at any moment. According to Dr. Choukas-Bradley, this mismatch can create the "perfect storm" for some young people who spend hours a day on highly visual social media.

This storm can intensify when teens become preoccupied with producing highly curated and edited images themselves. A team of researchers recently introduced a new construct to explain the psychological impact of constantly being "camera-ready." They have found that "appearance-related social media consciousness" predicts body image concerns and depressive symptoms over time.

It's not all bad, all the time.
Does this mean that social media is the sole cause of body image issues or disordered eating? No. Many young people benefit in important ways from the connections and community they find on these platforms.

Beauty ideals are culturally constructed, and many young people curate their feeds to seek the healthy representation of their identities. This can be especially powerful to kids who don't see themselves reflected in their communities or in mainstream media. Others may proactively follow influencers that depict a broad range of beauty ideals and authentic representations of their bodies and lives.

We also shouldn't discount other well-known risk factors for body dissatisfaction and eating disorders in a narrow focus on social media. These include stress and trauma, racism, and food insecurity, among others. For many teens, social media may be magnifying and reinforcing existing vulnerabilities we should not ignore.

What can we do?
Right now, there is a lot of important discussion about platform accountability and designing platforms with adolescent health and development in mind. More research on the specific ways that race and gender interact to shape young people's self-worth and body image online and offline will help us better design platforms that center around young people's diverse needs.

In the meantime, though, we can talk to teens early and often about aligning their online activities with the things that make them feel better about themselves and each other. This kind of "values-aligned" media use can buffer young people from the more negative effects. Curating feeds for body-positive influencers, creating body-positive content, and practicing critical media literacy all matter.

Stay curious. Keep talking.
Let's be clear. Not all teens are eager to sit down with us to formally reflect on their digital lives. But just deleting apps without talking about these issues is likely to backfire. The onslaught of messaging about worth, value, and appearance does not begin and end on Instagram. Ongoing conversations with kids about these topics are protective across both online and offline activities.

Most of us know that social media doesn't reflect real life. But it often takes ongoing conversations and reflection to really know it. And part of growing up is getting to know ourselves and our self-worth well enough to be able to protect it.