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Can Treating My Mood Disorder Be a Little More Fun?

I have to admit that most treatment workbooks are dry… sometimes even boring.  I can recognize several problems with this.

  1.  Even people that are engaged, motivated, energetic, and generally not struggling with their mood are unlikely to get excited workbooks.
  2. Mood disorders (depression and anxiety among others) can make it difficult to concentrate and process information effectively, limiting the usefulness of workbooks.
  3. Most workbooks are designed by therapists.  That usually means the content is pretty solid; unfortunately, therapists are necessarily the greatest and creating engaging materials.

Despite those points, I do like clients to have a tangible resource, something with clear guidelines that they can reach for when they’re ready to work on their mental well-being.  I don’t want to rely entirely on what they remember from our sessions (see number two above).  I’d like to have some options that are a little less dusty.

Many other health initiatives have worked to make themselves more appealing to a general audience.  There are mainstream marketing campaigns for smoking cessation.  There are commercials airing nationwide and streaming online for healthier food options, working to convince people that food can be healthy and delicious. REI wants me to #optoutside. Even the CDC provides colorful infographics online.  They make TV shows immortalizing and glorifying people’s journeys of weight loss and improved fitness (the problems with these programs will have to wait for another blog)

Mental health seems to be a harder sell.   There is no mental health treatment equivalent to Zumba.  The’s no cutting vegetables into fun shapes to make sure we’re having fun while eating healthy.  I’m starting to sound pretty pessimistic, but there’s hope.

Some people have taken it upon themselves to focus on the delivery just as much as the content.  I’ve shared Jane McGonigal’s work with Superbetter previously and haven’t found a better example of gamifying recovery anywhere.  One example of applying the concept of producing an engaging intervention in the written form is a collaboration between clinician Russ Harris and illustrator Bev Aisbett.  The result was The Illustrated Happiness Trap and it’s great for those interested specifically in Acceptance and Commitment Therapy.

A more recent discovery, and probably the more effective example of making a mental health recovery book fun is Rock Steady: Brilliant Advice from My Bipolar Life by graphic artist Ellen Forney.  With humor, pragmatism, and clever visuals she translates the dry academic wisdom of clinicians into something very relatable, accessible, and manageable.  Her book is built upon her experiences with managing her own bipolar disorder.  She acknowledges the struggles inherent associated with emotion regulation and self-care and delivers clinically sound advice.  According to Forney, the foundation of health can be boiled down into SMEDMERTS! (Sleep, Medication, Eating (well), Doctor, Mindfulness, Exercise, Routine, Tools, and Support).  The acronym is solid and the mascot is even better.

If workbooks or traditional self-help books aren’t for you, don’t give up hope.  There is more and more diversity in the options for a structured resource that can help you when you’re not with your therapist.  If you’ve got other suggestions, comment below.

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Mental and Emotional Fitness

My perspective on mental health continues to move further and further from the traditional medical model.  Identify symptoms, track causes, treat the disease – repeat.  I’m a much bigger believer in a preventative health model, the model that states we can avoid many illness and recover faster from the ones we do encounter IF we are taking good care of ourselves along the way.  The preventative model, while not actively implemented, is universally accepted.  I don’t know anyone that argues against the idea that regular exercise and a healthy diet can prevent many diseases and improve recovery rates for many others.

It’s important here to distinguish between being mentally and emotionally fit and being happy.  These are two extremely different things.  Happiness is a impermanent emotional experience.  Fitness is a slow-to-change state of being.  In the course of building and maintain fitness in this realm, I’m confident that there will be increasingly more opportunities to feel happy.  However, just like being tired one day doesn’t mean you’re not physically fit, being sad or anxious one day (or a few) doesn’t mean that you’re not mentally/emotionally fit.

Things are more clear with physical well-being.  Everyone knows that smoking cigarettes, consuming excessive alcohol, and subsisting on Doritos and Mountain Dew may have serious health impacts.  No one expects to be healthy when they consistently avoid healthy behaviors and engage in unhealthy behaviors.  No one is surprised when their doctor tells them that regaining health will require a change in lifestyle – consistent, long-term changes in diet and exercise.  We all accept the fact that physical fitness comes through committed effort.

It’s the same for our mental and emotional fitness.  It’s just harder to see.

Many people fall into patterns of mental and emotional sabotage then lament their lack of contentment.  They engage in unhealthy behaviors every single day then honestly wonder why they don’t feel mentally and emotionally well.  They judge, criticize (themselves and others), focus on the worst part of their day, build walls of righteous anger, fill the world with blame and shame, fail to communicate assertively, ignore their feelings, neglect boundaries, compromise their values, and passively watch life go by….then they complain about not being happy.

It’s the equivalent of someone watching their twelfth straight episode of “House of Cards” on Netflix, finishing off a pack of cigarettes, and washing it down with the last swallow in two-liter of Mountain Dew and pondering, “Why isn’t my body in peak physical condition right now?”  It sounds a little silly, but many people expect mental and emotional well-being without the work.  They expect fitness without committed effort or significant changes.  To be fair, it can be easy to mistake moments of happiness with genuine emotional fitness.  Unfortunately, it’s a costly mistake that allows people to justify a wide variety of strategies for exercising mental fitness.

The same way poor physical health makes physical injuries more likely and recovery more difficult, poor mental and emotional fitness can make people more prone to mental health “injuries” – diagnostic levels of depression, anxiety, substance use, etc.  as well as making recovery from those illnesses more challenging.

Now, physically fit people still fall ill and suffer some of the same maladies as those less concerned with physical health.  They can still suffer from heart attacks, broken bones, and pneumonia.  Mental illness is no different.  Practicing mindfulness, exercising gratitude and compassion, engaging in values-based living, and working to maintain a healthy mental outlook doesn’t guarantee  mental well-being.  Nothing can completely protect you from illness.  Mental and emotional fitness is about quality of life before, during, and after those illnesses.

So what’s it take to get fit?  The guidelines for physical fitness have been well defined.  According to the World Health Organization, adults benefit from spending at least 150 minutes per week engaging in moderate-intensity activities.  That’s 30 minutes five times per week, roughly 1.5% of your time each week.  Let’s apply the same standard to mental and emotional fitness.  Spend approximately 150 minutes per week actively engaged in becoming mentally and emotionally fit.  Whether that means meditation, writing a letter of gratitude, challenging distorted thoughts, practicing compassion, or seeing a therapist – carve out 1.5% of your weekly schedule and prioritize your emotional well-being.  Get fit.

As a therapist, people usually come to me after they recognize an illness.  The preventative piece is gone in terms of the present struggle.  I’m the cardiologist that meets the patient for the first time after the heart attack.  Not ideal, but it’s a place to start.  If I have the opportunity to work with someone on developing skills, building strategies, and creating a life-style, I’ve got a chance to help them get fit, to help them avoid (or lessen) future illnesses, to help them enjoy life a little more.  I’m grateful for that opportunity.