“Nothing in biology makes sense except in the light of evolution”

-Theodosius Dobzhansky

An introduction to The Six Pillars

I work primarily as a clinician in the NHS treating patients with a variety of complex physical and mental health problems. For the past 15 years I have been on a mission to demystify mental health and to empower people to take care of their own mental health. Of course – we all need expert guidance at times, but there are many things we can do to take charge of our own wellbeing. At Betterspace our philosophy is based around six simple, core principles everyone can use to maintain, improve, and protect their physical and mental health.

Mental health is a complex area. We believe that much of the confusion around mental health disappears when we remind ourselves of a simple fact: we are animals. And we have certain needs: the need for movement and sleep to allow critical biological functions; the need for connection with other people (or other mammals) for a variety of biological, emotional, and psychological needs, the need for engaging activity to promote purpose, reward, and prevent rumination ; the need for an other-focused or altruistic purpose; and the need to be able to countervail the corrosive effect of chronic stress.

There are many other determinants of mental health – psychological processes, our economic, political, social, and environmental surroundings; the experience of discrimination, trauma,violence, and abuse. All of these things of course are fundamentally important to health and wellbeing. Our focus at Betterspace is primarily those activities and experiences we can all build into our lives that promote good health and prevent ill-health. That is to say on those things which are immediately within each person’s direct influence and provide a foundation from which they can start to make daily habits which bring them towards improved health and wellbeing. We call these The Pillars.

To learn more about the extensive body of research that these pillars are based on – you can read our review of the evidence here.

Before we explore the pillars I’ll leave you with this quote from Hans Selye, the father of stress research:

“A long, healthy, and happy life is the result of making contributions, of having meaningful projects that are personally exciting and contribute to and bless the lives of others.”

― Hans Selye

The Brain: Sleep and Exercise

Sleep

“Everyone is looking for any possible edge they can get — sleep is that edge”

-Dr. Mark Rosekind – sleep expert with NASA and US Olympic athletes

Sleep is the sine qua non of good mental health. It may seem cliché to say this now that the importance of sleep has become more and more a focus of attention – but it is worth repeating: seven to nine hours of sleep per night on average is what virtually all people need to stay well. Sleep is a critical biological function which allows for repair of body and brain, and consolidation of learning. From the top level of mental health – to the simplest level of molecular and cellular health – there is no health without sleep. Most of us know this, but we don’t prioritise it. Sadly many of us have inherited an idea that surviving on less sleep is a sign of toughness, or that we don’t have time to sleep because we are too busy. But really we don’t have time to not sleep. Sleep is a superpower. Just ask Ariana Huffington.

Sleep problems predict mental ill-health at an alarming rate. A person with insomnia is six times more likely to develop depression, and a person with depression is six times more likely to have insomnia than the rest of the population. Treating insomnia in depression is as effective as treating the depression alone. 

For clinical levels of sleep problems – termed insomnia – by far the most effective treatment is CBT for insomnia or CBT-I. For those with less severe types of sleep disturbance, a range of options are available, because while sleep is universally important – it is also a very individual thing. Different people for instance prefer and benefit from different sleep environments and schedules. At Betterspace part of our core philosophy is that, because of the near infinite variety of human nature, a corresponding variety of solutions should be available. 

Top Tip: 7-9 hours per night, whatever way you can.

Exercise

“It is a shame for a person to grow old without seeing the beauty and strength of which their body is capable” 

– Socrates

The body, we seem to have forgotten over the millennia, has evolved to move. It is a movement Machine, but we spend our days lying and sitting. Physiological processes are dependent upon movement for their normal functioning. The normal functioning of the brain is no exception. Habitual exercise also blunts the physiological stress response and promotes neuroplasticity – the growth of new neural connections in the brain. The Academy of Royal Colleges in the UK has termed exercise “The Miracle Cure” such is the magnitude of the beneficial effect of exercise in the treatment and prevention of a huge range of health problems. Mental health is no exception. Exercise is one of the most effective treatments for depression and confers benefit in all types of mental health problems. It is also a crucial preventive factor – regular exercise is also associated with up to a 40% reduction in rates of new depression.

There are many different and equally valid ways to think of depression. What we term depression is probably a common endpoint of a number of different underlying problems – sometimes these are predominantly psychological, but sometimes they are predominantly physiological – a sedentary lifestyle, inadequate sleep, or poor nutrition. One way of conceptualising depression is that it is a signal that something is missing – in much the same way that loneliness or hunger are signals that something is missing. 

For a long time the focus of exercise has been on weight loss, performance, or aesthetics. This has led to exercise feeling like a chore for many people. When we emphasise the importance of regular movement for people’s health and wellbeing we also emphasise that it doesn’t have to be a chore. It can be fun, social, and exhilarating – whether you are hillwalking, skateboarding, lifting weights, or doing yoga – everyone is different. You can still be concerned with performance and lofty goals, or you can be like me and be more concerned with consistency and enjoyment. 

Top Tip: Get anaerobic (out of breath) most days. Whatever you do – make it a habit, make it social, and make it fun.

With sleep and exercise, we have addressed the biological functions that support the brain and wellbeing. Next week, we will be exploring the benefits of nourishing the mind through Meaningful Activity and Stress Management.