Dr Milli – Lifestyle Medicine Pillar: Mental Wellness

I am sure you have heard of the phrase there is no health without mental health? This refers to the fact that our health and wellness is formed by not just our physical health but our mental health, too: our thoughts, emotions and feelings. Problems can exist in our mental health in the form of stress, anxiety or depression, just to name a few. What’s more, poor physical health can cause poor mental health and poor mental health can affect our physical health.

So, mental health and wellness is such an important topic. It can have a profound negative impact on a person’s physical health, family, and work environment. We know 70% of GP consultations are related to our mental health. Moreover, our lifestyle can massively influence our mental state and vice versa; depression can lead to a lifestyle whereby we are eating poorly, smoking and drinking excessively, which can then cause obesity, hypertension and heart disease. A lifestyle of eating poorly and foods rich in artificial transfats can CAUSE depression, too. It’s a two-directional relationship between mental and physical health.

“What we eat can boost serotonin, physical movement can, too and other lifestyle factors.”

Management of a mental health condition will largely depend on the situation but can be broadly split up into self-help measures and lifestyle interventions, psychological therapies such as talking therapies and then medical management with various groups of tablets. One popularly used group of medications include a class of drug called selective serotonin reuptake inhibitors (SSRIs), which you may have heard of. They aim to increase the serotonin levels in the brain to improve our mood.

But let’s not forget lifestyle can be important for boosting our serotonin and mood, too. And this can be done in conjunction with medications if needed. What we eat can boost serotonin, physical movement can, too and other lifestyle factors.

Let’s take a case study of a woman in her early 50s struggling with depression, anxiety, poor sleep and more frequent migraines. She eats many processed fast foods and limits exercise due to knee pain.

She drinks 1⁄2 bottle of wine at night. She has two children, aged eight and nine and elderly parents who are in poor health and in nursing homes. She is currently going through a divorce and works in a toxic work environment.

THIS CASE HIGHLIGHTS MANY FACTORS; LET’S DISSECT IT.

1 Hormones – The first is how hormones can impact our mental health. This lady is of menopausal age, and so we need to ask about menopausal symptoms; ask her about her periods, ask about any hot flushes, etc. She states her periods are less frequent, less heavy and occur less often. This, in addition to her symptoms mentioned above, is consistent with the perimenopause. We know that oestrogen boosts serotonin levels in our brains.

So, this lady’s lowering oestrogen levels as her ovaries are preparing to retire means that her serotonin levels are lower, which can cause her to feel low. Replacement of her hormones with hormone replacement therapy (HRT) if she so wishes, and as long as there are no contraindications, would be an appropriate option to boost her mood.

2 Nutrition – this lady is eating a lot of processed food. Studies show that trans fats and processed foods are linked with depression. She should address her nutrition and ensure she eats whole, unprocessed foods to nourish her body and mind. Poor nutrition will also not harbour healthy gut microbes. Our gut health and microbes can affect our mental state – it has been clearly shown in studies that not only a poor range and number of healthy bugs in our gut is linked to depression, but it can actually CAUSE it.

3 Exercise – she is not engaging in any exercise. Yes, she does have a busy job and elderly parents to look after in addition to her children. And her low mood is probably giving her minimal motivation to exercise. But, we know from studies that exercise can be an effective strategy to prevent mental health issues, treat it, and improve our mood by boosting dopamine, serotonin and endorphins.

4 Alcohol – we know alcohol is a depressant. It will not be conducive to her mental state in the long term. She should cut down, and this may improve her mood. Furthermore, alcohol intake can cause disruptive sleep.

5 Sleep – adequate sleep is needed to maintain a healthy mental state. After a bad night’s sleep, I am a lot moodier and less able to cope with the day ahead. Seven to nine hours of sleep is ideal.

6 Social connections and relationships – this lady is going through a divorce, has young children and has a caring responsibility for elderly parents. To top it off, she has a stressful job in a toxic environment. As she is perimenopausal, her coping strategies from her lowering hormones are impeding her ability to cope. Discussion and looking at ensuring this lady has support from family and at work is crucial.

7 Migraines – Her migraines occur more often, possibly due to many factors. However, this physical issue may be related to her mental health and stress. Other causes could be dehydration due to alcohol intake, lack of sleep and her low levels of oestrogen as she goes through the change, which may trigger the migraines to occur more often.

As you can see, a delicate and intertwined relationship exists between our physical and mental health and lifestyle. There are so many ways we can try to improve our mental health. My favourite way is to walk in green space and listen to a podcast. I chatted on my podcast channel with a psychiatrist who embodies and practices the pillars of lifestyle medicine within her practice. It was a thought-provoking and insightful episode you could listen to on Spotify: The Dr Milli podcast: Boost & Biohack your health.

And last but not least, this month, I am very excited and pleased to announce the release of my book Happy Hormones, Happy You; six lifestyle secrets to empower your hormones for better health and happier living. It is a science-backed but user-friendly and easy-to-read book that takes the reader through the journey of our main hormones, our lifestyle, how they can interact, and what we can do to boost and hack our hormones. For more information on purchasing it, please head to my website drmilli.co.uk.

It is a great stocking filler and an investment in your health.

Out now. £13.99. Amazon.co.uk

Until next time.

Dr Milli x

NorthernLife Nov/Dec 23