Leaning in

11/05/2020

It is the eve of the election as I write this; many of the immediate unknowns will be known by the time you read it. My prayer for the coming weeks: May there be peace, and may we be released from the toxic trance that has held our attention captive. We have much else to attend to. I also pray that we receive guidance in the work of resilience building for the times ahead, along with the strength to bear the weight of that work and the heartful courage to navigate it with love and kindness.

In my primary care practice, I am moved by how many people are navigating existential crises. Major health challenges, sharp shifts in financial realities, homelessness and housing insecurity are each compounded by grinding social isolation and the complexity of life in a pandemic. Climate change and wildfire are throwing so much into play for so many. And the days are shortening, which, for at least 10 percent of us, causes a dip in mood. Many people are depressed.

Like you, I feel the challenges. There are too many variables in the “how to plan and prepare for the future” equation, and many constraints. I observe the habits of my mind, noticing the negative thought spirals and the conditions that favor their occurrence. I celebrate the way I feel on the days when I take really good care of myself and am better resourced to spiral back out of negativity. I am dismayed by the recurrent challenges that arise from our many outmoded systems—in my case, a health care system that is unable to structurally yield to the primacy of deep connection and thorough care. I see how essential self-care is for those of us wanting to lean into change-making for the long haul.

So how do we keep ourselves strong? How does care of the body enable our minds to stay out of the mire? 

Our mental state is inextricably linked to our physical wellbeing. There really is no separation. Not only that, but our mind-body wellness is directly linked to the way we weave ourselves into our local natural ecology. How does this web of wellness work? 

Let’s start with food. We are, after all, what we eat. We also have a whole community of bacteria living on and in our bodies: our microbiome. These little beings profoundly affect our health, influencing everything from our inflammatory state to our risk of obesity and heart disease to our mood, by making vitamins, neurotransmitters and other chemicals. We can help our microbiome support mental and physical wellbeing by feeding it lots of vegetables and fiber (especially flax seeds) and keeping the sugar, bread, cheese and saturated fat-containing meats to a minimum. In study after study, maintaining a healthy microbiome through these dietary interventions is found to impact our physical and mental wellbeing. This is even more true when eating veggies fresh from the (organic) farm or garden, especially when the soil has been nourished in a regenerative way. Taking in herbicides like glyphosate has been shown to not only harm our bodies but also impact our microbiome. We are what we eat, which is also what our microbiome eats. 

The way we eat also impacts our inflammatory state, another driver of depression. The links between depression and inflammation are just beginning to be understood, but we know they are significant. High levels of inflammatory cytokines affect the way our brain perceives and responds to threats and diminish available amounts of the mood-supporting neurotransmitters serotonin and dopamine. Although not all people suffering from depression have increased inflammation, there is a clear association. In people who have committed suicide, inflammatory cytokines have been found to be significantly elevated. These findings will help guide the development of new therapies for depression; they also help explain why eating an anti-inflammatory diet, taking omega 3 fatty acids (3 grams a day, more EPA than DHA) and getting regular exercise all helps mood. Sugar and processed, refined foods directly inflame the body and mind, and feed the type of bacteria in our gut that do the same. Reweaving ourselves back into a relationship with nature also has significantly anti-inflammatory effects. 

A balanced mood is dependent on a healthy level of serotonin in our brains; to make this neurotransmitter, we need to take in B vitamins, especially folate and B12. Many commonly prescribed medications can deplete B vitamins, and when people are deficient in B vitamins they experience depressed mood. Eating a diet rich in these foods is essential, such as dark-green leafy veggies, nuts and seeds, especially walnuts and pumpkin seeds. B12 can be found in eggs, animal protein and nutritional yeast. Taking a B complex can support healthy mood; studies show that taking 1 mg of folic acid along with an antidepressant makes therapy 40 percent more effective.

Our human bodies and minds are also governed by natural cycles of light and dark. Just like plants and other animals, we have genes that are switched on and off depending on the length of the day and the presence of light and dark. Our circadian rhythm governs many of our physiological functions, including our immune function and mood. When we live out of sync with cycles of light and dark (and the majority of us do nowadays unless the power is out), these rhythms are thrown off, and we feel less well. Studies show that the more closely we align our sleep-wake patterns with dark and light, the healthier and happier we are. For those of us genetically more susceptible to seasonal affective disorder or feeling depressed as days shorten, using a lightbox with 10,000 luxe light for 30 minutes each morning has been shown to significantly improve mood and sleep. Being outside in the morning with your face to the sun is another wonderful strategy to taking in light. Experiment with keeping lights low after sundown, using candlelight and limiting the use of devices in the evening. 

Our human bodies are designed to move. Being sedentary creates inflammation in our systems, while moving stimulates the healthy circulation of blood and nutrients throughout our body, dampening that inflammation. Intriguingly, exercise stimulates the growth of the hippocampus, precisely the part of the brain that shrinks in depression and dementia. Taking a vigorous walk several times a week has been found to be as effective as antidepressant therapy for mild to moderate depression, with a whole host of beneficial side effects. My favorite: dance parties in the living room with my girls. Lifts me out of a funk every time.

These foundational strategies put us in a better place to navigate the tremendous challenges we face. Yet we cannot address any of our systemic societal challenges in isolation. We must turn toward a regenerative, resilient, life-affirming way of living, and simultaneously midwife the passing of the old structures, in community. This is challenging work, and begs the question: How can we structure community around lifting each other up, and refrain from behaviors that unwittingly or intentionally pull each other down? Practicing reaching out for and offering support to friends and community members is an important starting place. Using our finest, most thoughtful and compassionate words at every turn—including on social media—elevates the possibilities in our discourse and our community building. It is good modeling for our children, and it may have a bigger impact on someone’s wellbeing than you will ever know. 

It is my prayer that in the coming weeks and months we will move ever toward a kinder, more compassionate society, that the inflammatory rhetoric will subside, and that we will be better positioned collectively to lean into the good work to be done.

 

Anna O’Malley, an integrative family and community medicine physician with the Coastal Health Alliance, founded and directs Natura Institute for Ecology and Medicine in the Commonweal Garden. Her twice-monthly Community Medicine Circles, now on Zoom, can be found at https://www.naturainstitute.org/integrative-community-medicine-zoom. Recordings of previous circles, including the most recent on mind-body wellbeing, can be found there.