Physical Interventions for Depression Treatment | Depression Recovery Tips

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs register@allceus.com counselortoolbox you I'd like to welcome everybody to today's presentation. This is the continuation of the series from 100 plus practical tools to defeat Depression. We did emotional and cognitive interventions last week. Today we're doing physical interventions and Thursday we're going to talk about spiritual interventions. So today's course is really pretty straightforward. We're going to identify why physical interventions are important to recovery and overall happiness. And we're going to explore some different physical interventions that we can use with our clients. I mean, we're not, most of us are not personal trainers. Most of us are not physicians or nurses. So we're not going to be prescribing medication or changing nutrition or anything like that. And please remember in most states it is a, what is it they call a practice law, whatever, that you have to be a registered dietitian in order to make nutritional prescriptions for any clients. So that includes menu or anything else. Now they can develop their own menus, but we can't do it for them. So it's always better to have them work with their physician or an rd. So there's a myriad of reasons why people use physical interventions to treat depression and anxiety. They release endorphins, serotonin, dopamine, and norepinephrine. All of these are happy chemicals. Now you've heard of that runner's high. You know, those are the endorphins that are released when you hit a particular point in your run. But you know, you don't have to get to the point of having a runner's high or having that endorphin release in order to get the benefits of exercise. Even moderate exercise for 20 to 30 minutes can increase serotonin levels, dopamine levels, and help us focus a little bit better. With some norepinephrine in there, it increases the available oxygen in your blood. Did you know that one of the main reasons that people yawn is not because they're tired, but because they are oxygen depleted? As Americans, we typically chest breathe and when we're not breathing through our diaphragm, we're not getting enough oxygen in. So exercise, even walking, helps us breathe a little bit deeper. When we get more oxygen, we're less foggy headed, we're less tired. Oxygen actually helps energize us. So, you know, there's another benefit. Exercise and physical Interventions have been linked to improvements in self esteem. When you're feeling more energetic, when you're feeling your uber self, you know, you're probably going to feel better about yourself. It helps you get your mind, thoughts and bodily reactions more in sync. You know, have you ever been stressed out? And if you went for a walk, it kind of helped sync everything up. Now there's a theory of counseling called bioenergetics that talks about how when we get stressed, our energy is just kind of filling up. And by using our big muscles like our legs, it helps pull that energy down and, you know, reground us and rebalance us however you want to look at it. Most people when they're stressed out, telling them to sit down and be still is like, oh my gosh, one of the most stressful things in the world. They need to move so they're. Because their heart rate is going. You know, when we have that stress reaction, we have that sympathetic reaction where our respiration goes up, our heart rate goes up, our temperature goes up. Well, all of those are the same things that happen when we're exercising or moving. And if we're sitting still, our body's going, okay, there's a disconnect here. I'm not sure what's going on. So one of the ways that helps people kind of get in sync and get everything back flowing, right, Is to move that body. It can put you in a place where you can engage with other positive people. Whether it's hiking, on a trail or at the gym. Most of the time the people that are there are at least neutral, if not in a relatively good mood. It can help you with gentle aches and pains, which can disrupt your sleep and put you in a bad mood. And we'll talk about muscle imbalances, but when you have muscle imbalances, it causes muscle spasms. These muscle spasms can cause pain. One thing that people don't think about a lot is the fact that when you have excessively tight hamstrings, it causes can cause low back pain. Or when you have very weak abdominals, it can cause low back pain if your back muscles are stronger. So, you know, those are two of the things that physical therapists work on with people who have low back pain. But think about how low back pain impacts your day, if you've ever hurt your back, or if you just have chronic low back pain. You know, you're walking around like this all the time. I know I am right now because it's planting season and I spend a lot of time Bent over, and then I stand up and I feel like I'm about 80. Okay. Physical interventions can help you turn down the stress response so you sleep better. Have you ever had one of those really stressful days and you just sucked it up and you went to the gym or you went out for a run or a walk or whatever it is you do, and you felt better afterwards? All that cortisol, all that adrenaline, all that stress that you had coursing through your body, you used that energy to exercise, to move. And exercise can actually help increase energy. Using one of Newton's laws, a body in motion tends to stay in motion and a body at rest tends to, well, be stuck, stay at rest. So again, think about it. If you've ever been stuck on the couch for a week or longer. I know when I was on bed rest with my daughter, I was on bed rest for three months. And I never knew how tired staying in bed could make you. I was exhausted all the time. So when you get up and you move around, not only are you getting your blood circulating and getting that oxygen around, improving your self esteem, but it helps you get a little bit of energy so you feel brighter. So one of the first things that we can use for interventions are yoga and meditation. Now, this is obviously calming. It's not energetic, but sometimes helping people figure out how to calm themselves down when they're angry or stressed out or after a long day can really help them get into that zone where they can get good quality sleep. They found that the brain chemical gaba, which is our main calming neurochemical, it's the one that your benzodiazepines, you know, triggers. GABA increases after a session of yoga. It produces significant improvements in tension, anxiety, depression, dejection, anger, hostility, fatigue, inertia and confusion bewilderment. You have to be a researcher to come up with those dimensions. But they did find that yoga can provide significant improvements in each one of those dimensions after just about 20 minutes a day, five days a week. That's not too bad. Now, not everybody likes to do yoga. I know. I get frustrated because I can't remember all the positions and the poses and everything. So if yoga is not for you, then that's fine. We don't want it to be something that increases your stress. But if you work with a good instructor, you can probably get to the point where yoga is helpful and relaxing. It also does a lot for balancing those muscles like I talked about, which relieves tension meditation. There are lots of different types of meditation and it quiets the mind. You know, as Americans especially, we're thinking constantly about this, that and the other. We are not present, focused, we are not mindful. Most of the time we're thinking about the past, we're thinking about what we've got to do. Even driving home, we're not thinking about driving, we're thinking about what we've got to do when we get home, what we're going to make for dinner, you know, yada, yada, yada. Meditation quiets the mind. It forces people to find a singular, all encompassing present focus, whatever that is. 20 to 30 minutes of meditation per day produces consistent effects for anxiety and depression. So one of the things that you can do, and they've done research with this, which is really cool, having people just watch a fish tank actually is sort of a form of meditation. If they're sitting there and they're just watching fish swim back and forth, they found measurable decreases in heart rate, respiration, muscle tension, and perceived stress. So it's something to consider. Now there are always, you know, the odd people out like me. You know, I don't mind. I love watching Betas and that sort of thing, but goldfish poop a lot and, you know, I just can't watch a goldfish swim because of that issue. And I know you're going, really? But yeah, that's one of my little idiosyncrasies. It's not relaxing to me to watch a goldfish go to the bathroom. Most other fish don't seem to do that. I've seen lots of other fish tanks, but that is one suggestion to add in your waiting room. So while people are sitting, sitting there waiting for their appointment or after their appointment, if they just want to, you know, collect themselves for a few minutes, they can watch that fish tank and get into their little Zen zone. Experiment with different types of meditation over several sessions, either in individual or group work. And this link obviously is in the PowerPoint 23 different meditation techniques. So I mean, if you do one a week for 23 weeks, that's six months worth of different meditation techniques where you can have people try different things. You can also have clients try a different technique each day and rate how they like it. Focused attention. Meditation focuses the attention on a single object during the whole session. It can be their breath, a mantra, a visualization, or an external object like a candlestick. When I was little, I used to love to watch the fire on the candle. I don't know why, but I did open monitoring meditation. Instead of focusing the attention on one Object, we keep it opening, monitoring all objects of our experience without judgment or attachment. This one can be really frustrating for a lot of people because it's hard to stay open and not get attached and just let things come in and go out of our awareness. Effortless presence. Zen meditation. You know, you can go down this list. We're not. I could do an entire hour or more class on meditation. My point being, there are dozens of different types of meditation. So if you've tried one and it hasn't worked, or if your clients tried one and it hasn't worked, suggest different ones. And sometimes the word meditation brings odd connotations to people's mind or distasteful or whatever you want to say. So sometimes I will just call it an activity or an exercise. And then afterwards we process it. And I say, well, this is a form of meditation. And they're like, oh, okay, well, that wasn't what I think of when I think of meditation. So those are different ways you can use it. I've used these techniques when I taught stress and anxiety management in a university setting as well as in a clinical setting. So you can do them with groups and have people experiment with them and talk about what they liked and what they didn't like from each one. And I will take that under advisement. I will do a class on meditation at some point. I can't guarantee exactly when, but I will work one in there if y' all are interested in it. Okay. Exercise is the next form of relaxation. Some people love to exercise. I love to exercise. It helps me clear my mind, starts my day off right. It's a great thing. Not everybody likes it. Physical activity helps balance muscles. So you don't have muscle imbalances causing muscle spasms. It releases muscle tension. If you carry your stress in your shoulders or your neck, if you do some physical activity, it can help release those muscles. I know after about mile four, I can tilt my head one way or the other and my neck pops up. Until then, I've just got all this stress. But I know that's one way I can get my torso to relax. It increases oxygen flow, serotonin, and improves sleep. You know, when we're not in pain, when we don't have a lot of cortisol coursing through our body. When we're able to calm down, we can sleep better. So one thing I do with groups, and you can do it with an individual as well, is we talk about 10 ways to make exercise fun. Exercise doesn't have to be going to the Gym or lifting weights or doing aerobics or running or, you know, something that people can find distasteful. When I lived in Florida, I created a Mommy and me curriculum for parents of children up to 18 months old. And we used the children as resistance, you know, and you can play with the baby and pick them up and, you know, do all kinds of things and work just about every muscle in the body. And it's fun. The kid enjoys it, you enjoy it. You can play with your dog. If you've got a dog. You can clean the house. You know, vigorously cleaning the house burns calories and gets that body moving. I mopped the floors this morning and I was, you know, I was done when I was finished. But encourage them to think about other ways to make exercise fun. Doing it with a buddy. I love going on hikes. You know, if I can find time to go to a park and get out in the woods. Love that. Especially when the chipmunks are out. Encourage them to be creative. You don't necessarily have to exercise for, you know, 30 minutes in a single block, especially if you haven't been exercising. So encourage people to sneak it in five minutes at a time. Better than nothing. Group activities that you can do to make exercise fun. Balloon toss. This is one of my favorites. You know, get three or four balloons, get everybody in a circle and toss them up in the air. And you're not supposed to. Supposed to let the balloon hit the ground. Yes, it's a game you play with 4 year olds, but it's a game you can play with 40 year olds and it can be pretty darn fun. Learn a dance. Some people. You know, depending on your group, you might have a group that's willing to learn to do a different dance. Anything that's currently popular or not. You can learn the Macarena or something else that people. The electric slide. Whatever it is that people want to learn to do, that's movement. Square dancing is movement. Line dancing is movement. Or just take them on a nature walk. And even if you are in the city, there's probably somewhere or hopefully somewhere that you can go around your office or complex, or they can go around their house where there's a little bit of nature, where there's a bird here and there. You may not have parks, but if you do, all the better and just pay attention when they're exercising. If you go to a park and you're walking on the track or the trail, pay attention to the leaves and the sounds and you know what you're feeling like the air and the sun and that sort of stuff. Not feeling like I want to go home. But being mindful in the present moment can make exercise relaxing. Stretching is another thing. And you know, if you get a little bit of input from a personal trainer or whatever, stretching, you pretty much are probably not going to hurt your clients. You don't want people with back pain or problems or anything doing this without supervision. But it's something you can suggest because muscle imbalances cause pain, can impair sleep and mood, as well as keep stress chemicals high. When we are in chronic pain, our body keeps our cortisol, our stress hormone higher than when we're not in pain, which means we're not sleeping as well. So, you know, and it's this negative feedback loop. Most people's imbalances because of the way our body is created, there's two planes, there's front and back. So your abs and your back, or your back and your chest, biceps and triceps, you know how it goes. Or your left and your right. And obviously left and right has more to do with your core. Either side of your spine, you've got different sets of muscles. For example, I have scoliosis. So on one side of my, on my spine is stronger than the other side of my spine. And they're constantly doing this tug of war thing. So stretching is helpful as well as physical therapy. But stretching can be something that's done as a group and you don't have to do these huge in depth stress stretches. You can just do desk stretches and you can Google those, you know, where you stretch your upper back, you stretch your neck. Never stretch, never put your head straight back. That puts too much pressure on those little tiny vertebrae in your neck. But stretches that people, it's suggested that people do, if they have do a lot of desk work, it can be something you do in group, between. Activities at work. You can have people stretch or between activities in group. If you take a break, encourage people, not just, you know, take a break for a few minutes. But why doesn't everybody get up and stretch for a minute and then go on? Oh, and Heather Cray suggested chair dancing for people who are wheelchair bound or people who don't have the leg strength for people with disabilities, for people who are elderly. Tai chi is also fabulous for relaxation, muscle strengthening, oxygenation, all that stuff. Hobbies are another sort of physical thing for relaxation. It can help you use up some of that nervous energy. I'm one of those people, I can't sit still. I'm kind of Like a, I don't know, a squirrel or something. I am not one to sit on the couch and watch an entire show for an hour and not move. I've got to do something. So hobbies can help you use up some of that nervous energy and enable you to get into a calm mind space. Have clients brainstorm what hobbies they have. What do they like doing? Cooking. You know, I love cooking, building things. I'm not so good with woodwork, but, you know, my mother in law, for example, loves building, planting, crocheting, reading a book or writing a book, any of these things. And there's a myriad of other things. Building model airplanes or whatever strikes people's fancy. But if they start brainstorming in group, then people are going to say, oh yeah, I forgot about that. I hadn't even thought about trying that particular hobby. You can have people with a particular hobby share with the group. Spend 10 minutes at the end of every group for eight weeks having people share their hobby and teach a little bit about it if you want to, or integrate it into an activity you're doing. If somebody has a hobby of painting, great. Have them share that. When you do an art therapy project, hobbies can also help you get out some of your stress. Painting, for example, you can paint pretty aggressively or you can paint what you're thinking. If you're thinking about a tornado of things, you can express that on the canvas and get it out of your head, so to speak. Yard work, I've shared with y' all before. When I get stressed, I go out and I do yard work. The more stressed I am, the bigger the power tool and it just helps me to be destructive. It's very cathartic or, you know, some people like doing construction. If you're turning a house or something, obviously the demolition part can be a lot more fun than necessarily the construction part. But that's just me. So have people share their hobbies. And you can also have hobby stations. Tell people the week before we're going to talk about hobbies when you come in next week. So, you know, if there are eight people in your group, have eight hobby stations and people can go around and learn from one another what their different hobbies are, how to do them, that sort of thing. Speed hobbying is something that Kathy brings up and I'd never heard of that, but that does sound fun. I'll have to Google that later. Nutrition. Your body needs those building blocks to make the brain chemicals that keep you motivated, happy, and you know, even let you feel stressed. We need to provide the fuel and the resources for your body to function. It gets these building blocks from healthy food. And taking vitamins is not a replacement because food has vitamins and minerals and very specific ratios that make them more bioavailable. Taking mega supplements doesn't have it in that same ratio. So ideally, it's best to get the nutritional stuff from actual food. Obviously, clients may need to consult a physician or a registered dietitian. And some people on restrictive diets or who have malabsorption syndromes like celiac disease, Crohn's, or ulcerative colitis may need additional vitamins, but they need to talk with their doctor about that. Some biological causes of depression can be linked to poor nutrition, which keeps the body from being able to make the brain chemicals to support your mood. So, like I said at the beginning, we don't want to make a prescription for people to change their diet. That's out of our scope of practice. But what we can do is teach them about different foods and, you know, world's healthiest foods. I think it's WHfoods. WH. But you can identify the top 15 foods that are highest in vitamin B6 or calcium or whatever. Encourage them to explore. I also have some videos on our YouTube channel that go through those exact things and have people create a healthy menu for the week based on the foods they like to eat or they're willing to eat. Encourage them to eat colorfully. You know, three colors on their plate at every single meal. That's. That's generally doable. And different shades of white don't count. So that's one thing that, you know, you can do. You can even do it as a group. You know, put a big on the whiteboard, make a hypothetical menu. We're not telling people to necessarily follow it. We're just talking, brainstorming, and practicing creating menus. That way, when people go shopping, they get the stuff that they need, so they have the building blocks available to make the dishes that they want. Another creative, fun thing to do in group is have people identify ways to sneak in green vegetables. If you've got kids or even some adults, you know that sometimes it's hard to get people to eat their vegetables. So how can you sneak them in? There are a lot of different ways. It's harvesting season right now, and we're getting zucchini like crazy. So we're making zucchini bread, zucchini pancakes, fried zucchini, zucchini noodles. I mean, we're finding lots of ways to include zucchini kale is the same way. Kale chips, sauteed kale. We come up with a lot of different things. We feel kind of like that guy on Forrest Gump, but trying to figure out how to sneak it in so kids and people who don't like their vegetables will eat it. Can you put it in some sort of meatloaf? Can you put it in some sort of casserole? What can you do? As an aside, a lot of the brassicas, your kale, and even your sweet potato greens that are kind of bitter when you saute them, it takes the bitter out, so you just saute them till they turn bright green and they taste a lot better anyhow. You can also do, if your agency approves of it, a potluck where everybody can bring in a dish that they like to eat, a healthy dish that they like to eat. So that can be fun. It can be, you know, you can involve it in cultural responsiveness or something if you want to, but it helps people share different ideas. Now, one of my favorite things is sleep, and it's the time when your body rests and rebalances. They've done studies. They found, despite what some of the research said back in the 70s and early 80s, we actually do need sleep. When we don't get enough sleep, our immune system goes down, our blood pressure goes up, lot of bad stuff, stuff starts to happen. We need sleep. When we're sleep deprived, our cortisol levels go up and stay up because we are not on our A game, and our body recognizes that. So it's trying to help us stay awake with cortisol and adrenaline and stuff. And that's not good for your body or your blood pressure. Lack of sleep results in your body being under stress. So one activity is to develop a sleep routine with people. When we have kids at home or. And generally it is with kids, we tend to forget this when we get older. But with kids, we say, okay, you come home from school, you play for a while, we eat dinner, you take a bath, I read you a story, you go to bed, and bom badam badum. That's the way it happens. Well, as soon as the kid comes home from school and they start on that routine, the body cues in, the brain cues in and goes, okay, it's about time to start making melatonin. I know what this routine means. And people get on a schedule, but it has to be relatively consistent. So we want to talk to people about what is your sleep routine? What do you do to cue your body in to let it know that, hey, it's about time to go to bed. Other things that you can do is talk about things that impair sleep and what you can do to help yourself sleep. For example, some people lay down and their mind just races. You know, they're like, I need to remember to do this tomorrow, to do that tomorrow. Oh, I've got to pick milk up at the store. You know, keep a notepad and a pen by your bed with some sort of a, you know, one of those headlamps or a flashlight that has a red light filter on it. You don't want to use a white light because that triggers your brain to wake up. But if you use a red light, just like in the exit signs, it doesn't disrupt your night vision near as much, but it gives you enough light to see so you can write down what you need to. A lot of people find when they get it out of their head and they don't have to remember to remember it, they can go to sleep a little bit easier. Sleep routines can help not exercising within three hours of bed. Your body needs to cool to go to sleep. So you also don't want to take a hot shower right before bed. Body needs to cool in order to sleep. Keeping just about everything out of the bedroom except for sleep and sex generally more helpful if you're sitting there working up until, you know, the minute before you go to bed, you know you're bringing stress into that room. You want your bedroom, wherever you sleep, to be sort of a sanctuary. And there are a lot of other tips and tricks. I have another video exclusively devoted to sleep, why it's important and how to improve it. But you can look at that if you want to later. We also want to dispel myths about things like antihistamines. A lot of the sleep aids on the market now are diphenhydramine, which is Benadryl. Benadryl's nanohistamine, yes. It helps you fall a sleep faster, no doubt. However, the quality of sleep tends to be a lot worse when you're taking something like that in the studies that they've done. So, you know, would you rather have 10 hours of, you know, crappy sleep or seven hours of really good sleep? So helping people kind of wean off antihistamines. Alcohol is also something that is a system depressant, but it impairs the quality of sleep. It also aggravates sleep apnea. So if somebody has sleep apnea, because alcohol slows respiration, it can make the apnea Worse, which also makes sleep worse. And in response to Jesse's question, I don't ever recommend any sort of supplement or medication to clients. When clients ask me about melatonin because it's out there or any of the sleep aids, I really encourage them to talk with their doctor because, you know, I don't know. I don't want to guarantee that I know all the meds that they're on or the complications that they may have. Now, the sleep foundation on online, I think it's sleepfoundation.org does recommend melatonin for sleep, but they actually recommend like a third of a milligram is being plenty for sleep. Whereas I know a lot of people start out taking like 3 or 5 milligrams, which is way, way too much if you read their studies. So, you know, again, dosing, contraindications, just the fact that it is something they're ingesting, which is outside of my scope of practice, I try to avoid recommending it. But if they ask about it or, you know, if they're asking if there are alternatives, I will point out, you know, that there are. There are these alternatives out there. But it's important to figure out what the right dosage is for them by talking with their doctor. And I hedge those things like crazy because I don't want them to think I am recommending it for. For them. Pain management. Pain causes increased cortisol levels, impairs sleep, and creates an irritable mood. It can be caused by an injury or an illness. So if you've got Crohn's disease, that can cause pain. If you've got a back injury, can cause pain. If you have muscle imbalances, it can cause pain. A lot of women, and I'm guilty, I periodically have to watch myself. But because we carry our purse on the same shoulder, we tend to walk around with that shoulder a little bit higher, which causes muscle imbalance. Incorrect exercise habits, such as always working on your biceps and your chest. Well, then your triceps and your back are too weak in comparison, and you're going to have those muscles fighting against one another. Repetitive physical labor can cause pain. It can cause, like, repetitive stress injuries. But, you know, even something like roofing, where people are bent over all day long, you know, they're strengthening their back by being bent over, but it can cause pain and muscle imbalances. Poor ergonomics. Now that I've switched studios, y' all probably have noticed that I'm bad and I sit crisscross applesauce in My chair most of the time. That's not good ergonomics. So a lot of things that we do when we're sitting at our desk or even when we're sleeping can add extra stress and pain and muscle problems. And finally, stress. Stress itself can cause pain. If you're holding your stress in your muscles or even just being stressed, it can upset your belly and cause belly pain, can cause low back pain. There's a lot of pain that can come from stress. Additionally, when cortisol levels are high, it keeps serotonin levels lower than they normally would be. Serotonin is one of those chemicals in addition to substance P that is responsible for your pain tolerance. So when you don't have as much serotonin, your pain tolerance may be lower. Interventions for pain management. Non pharmacological interventions. TENS units. TENS units are awesome. And you can actually buy them over the counter now. They're the electronic nerve stimulation sounds horrible, but it's actually awesome. It feels like somebody just kind of tapping at you. It's not anything that's painful at all. If you've ever had a shock collar on a dog or something and accidentally shocked yourself, it's nothing like that. That's pretty horrific. Or put your finger in a light socket, nothing like that. It's very, very mild. But basically it bombards the nerve endings and overwhelms them so they stop sending the pain signals while it's on. And that can give you a little bit of relief so the muscles can relax. Hot tubs, heat heating pads, those can be helpful. Ice, that's one of my favorite actually. Ice can be helpful for pain as well because it reduces inflammation, stretching, muscle rebalancing. And this is more of an exercise physical therapy thing. Massage can be helpful if you can stop the muscles from spasming. If that's what's causing your pain, which massage can often do, then it can can help the muscles repair and rebalance. Guided imagery can be helpful with pain. And one of the things that you'll notice is when you've got pain, if you focus on gets worse, you know, if you're fo and the same thing with emotions, if you're focused on your depression, you can really just get stuck in that depression. If you're focused on getting a shot and you just know it's going to hurt, then, yeah, it's probably going to hurt. When you focus on something else, it can take your mind away from that pain. So if you've got pain in your back, then focusing, you know, on how your Foot feels can be helpful, or focusing on a pleasant sensation somewhere else in your body can be helpful. There are a lot of guided imagery techniques for pain management. Again, I could do a whole hour class on different guided images for pain management, so Google those if you're working with a client that has chronic pain. And stress reduction helps with pain because it increases serotonin and reduces muscle tension. Whatever helps people reduce their pain. When I work with clients who have chronic pain, and most people do at some point in their lives, you know, we talk about, we'll do a group brainstorming. What are different things you do to deal with your pain when it's untenable, when it's keeping you up at night, when it's chronic, in order to help you have the highest quality of life. And people come up with all different types of suggestions. And usually I'll find one or two that I had never heard of before. So that's always, you know, a bonus to working in groups because I always learn something from, from my clients. So playing Family Feud for nutrition, sleep and nutrition, sleep and pain management, family viewed, kind of modified can be really fun. So create a board for each of the following questions and any that you make up. And the questions are on the next slide. Each response on the board is worth one point. So in Family Feud, you know how it's like it varies in its point totals. Well, we're not polling anybody, so everything's worth a single point during the initial face off. You know, when they go to the front, whoever answers correctly first gets control of the board for their team. Yeah. If a team identifies all answers correctly in a category, they get 15 bonus points. Any answers that are not chosen, such as what are the top five aromatherapy scents to help people relax? You know, and if you haven't done a class on this before or it's been a while, you may not get all of them. The teams may not get all of them, and if they don't, that's fine. Any answers that are not chosen, we want to present them and explain them. So this gamifies it, makes it more fun instead of just sitting there for a lecture. If a team strikes out, the other team gets an opportunity to respond. If they do so correctly, they get the point and retain control of the board. So it's a lot like Family Feud, just the scoring's a little bit different. So questions you can ask. What are five things you can do to improve sleep? You know, get a sleep mask, put on earplugs, develop a sleep routine, stop drinking caffeine 12 hours before bed, don't smoke within two hours of bed. I mean, I can list about 15 things. So what are five things? What are five essential oils that help with sleep? What are five things you should not do before bed, such as take a hot bath, exercise, you know, eat a big meal? What are five things you can do to improve your nutrition? And these are general. We're not talking about prescriptions here. We're talking about drink enough water, make sure we're eating enough vegetables, cut down on saturated fats. What are five good sources of B vitamins? What are five things you can do to help you to relax? What are 5 non drug ways you can manage pain? What are 5 causes of muscle pain and 5 fun types of exercise? So this, I mean just these questions alone could easily take up an entire therapy hour. But it helps people review some of those physical interventions and keeps them fresh in their mind. So a healthy body is necessary for people to feel their best emotionally when, you know, think about when you're sick or when you're in pain or, you know, or when you're just blah, you know, we're not feeling our best emotionally. I know I tend to be kind of a grumpy pants when I'm in pain. So it's important to help clients recognize the fact that in order to feel less depressed or less anxious or happy or whatever they want to call it, it's going to be important for them to take care of their bodies. And I encourage clients when they start thinking about physical interventions. Some clients are gung ho. They're like, okay, this is easy. I can do physical interventions. Those, you know, don't hurt emotionally, like talking about traumas or, you know, the hard stuff like changing cognitions. I can work on walking for 20 minutes a day. That's a no brainer. Whatever they do in that biopsychosocial system to improve their overall health and happiness is going to have a positive effect system wide. So if they're motivated to take on any of these physiological interventions, by all means, let's do it. But encourage them not to be extreme. You know, they're going to have a much better time sticking with the goals and using these interventions if they do small changes. So instead of going from a couch potato to trying to run a 10K, going from a couch potato to walking 30 minutes, four days a week, that's doable. Once that's simple to them, add something else on top of that same thing. If they're wanting to improve their nutrition, you know, Instead of saying, well, I'm going to start eating five servings of vegetables and drinking half a gallon of water and da da da da da da da. 17 things they're going to change. Have them pick one. Pick one this week. You know, if you want to start drinking more water, it actually helps when we're dehydrated. 1% dehydration increases confusion and reduces short term memory. 2% dehydration makes it harder to problem solve. That's not very much when you're 1% dehydrated, you're not even really thirsty yet. By the time you're thirsty, you're already experiencing significant cognitive impacts from that dehydration. So you know, something as simple as drinking enough water can help people feel a little less sluggish and foggy headed and confused. And then once that's easy and they see that they're doing that regularly, then they can change something else. You know, maybe they want to get, get rid of high fructose corn syrup or something. Whatever it is they want to do, they take that change. They have built these nutritional habits over 20, 30, 40 years. Remind them to take it slow in changing them. It won't take 20 years to change it. But don't expect to change everything overnight. Brain chemicals that help people feel happy and relaxed are created from the foods they eat. Again, you know, that doesn't mean you can't ever have pizza again or you know, something from Dairy Queen or whatever it is that you love. You know, I love chocolate. I have chocolate every day. I don't have a lot of chocolate, but I have a little bit every day. Because as soon as you start cutting things out and saying, I can't have that ever at all anymore, the easier it is to set yourself up for a binge, especially if it's something that's easily accessible, like cookies or chocolate or something like that. So ideally, help them eat it in moderation. In group. You can brainstorm ways to moderate, you know, junk food intake, such as instead of buying the 1 pound bag of M&MS, get the snack size. You know that it's already portioned out. So if you're determined or if you know you're the kind of person that's going to eat the whole bag, make sure it's a small bag that you're going to eat instead of the one pound or five pound or whatever it is. Don't go to Sam's and get M and M's. That's one thing. You can also restrict yourself to having Those treat type foods when you're not in the house, you know, don't keep them in the house, but when you're out and about, you can indulge in something like that that makes it less accessible so you've got healthier foods. And then also substitute healthy foods for, you know, some of those treats. But don't substitute celery for chocolate. It's not going to be satisfying. When I'm craving chocolate, if I don't have it around or I don't want to eat it at that moment, I have an apple, you know, it's chewy, crunchy, it's juicy, it's sweet. It satisfies that sweet craving that I've got at that particular point in time. So make sure that they've got things that they might be willing to substitute. It's not an exact one for one, but it can help with those sweet or salty cravings. Sunlight. We actually didn't talk about this, but sunlight sets your circadian rhythms so you can get good quality sleep. And they found that there are hundreds of vitamin D receptors in the area of the brain responsible for mood. They don't exactly know how it relates to mood or how it works, but they know that those receptors are in the emotion section of the brain. Which makes sense because when people's vitamin D is deficient, such as during the winter, people tend to feel more depressed. So going outside, getting sunlight, vitamin D that is gotten by sunlight, is much, much more bioavailable than any vitamin D pill that people can take. So encouraging people to. And you don't have to bask in the sun. All you need to do for most people is when you're walking to and from your car and maybe sit in front of a bright window, but walking to and from your car every day, it's like 15 minutes, three times a week is enough to keep your vitamin D levels up. Most anybody can do that. But sunlight, we need to set our circadian rhythms. I worked with a therapist who used to keep her office very, very dim. And when my son was in the nicu, the neonatal intensive care unit, they kept the lights very, very dim in there. And I'd sit in there for, you know, 8, 10, 12 hours at a stretch during the day when I was supposed to be awake and my body didn't know when it was supposed to be awake and when it was supposed to sleep. So it's good to start your day by a bright window, get that sunlight in. And during the day, even if you're not seeing Real sunlight stay in a brightly lit room. Now, light therapy is not the same as a brightly lit fluorescent room. Light therapy has a very specific intensity and brightness to it and color spectrum to it in order to have the same benefits as actual sunlight. People can get those bulbs and they can get, you know, sunlight therapy boxes that have been shown to be very, very helpful, especially if they're in a place that gets a lot of rain or is dark, like Alaska, where it's, you know, six months out of the year, it's pretty much dark all the time. So sunlight can help people exercise. Stretching and yoga all help increase the happy chemicals, reduce pain and improve sleep. So any of these things, if somebody's not up to exercise yet, encourage them to explore stretching or yoga. You know, they may not be ready to exercise or wanting to do that yet. That's fine. You know, I'm not. I don't want them to do anything that's going to make them more unhappy. And remind clients that pain is a fact of life. There are many options for pain management other than drugs, reminding them that many medications for pain are system depressants. Opiates are system depressants. They are going to slow you down, they're going to slow your heart rate, your respiration, you're likely going to feel foggy headed, tired, you know, a lot of symptoms of depression. So we do want to encourage people, especially if they have tendencies towards depression, to examine alternate approaches to pain management. Other videos on any of these topics. I did an entire series on preventing vulnerabilities and it's the preventing vulnerabilities playlist. It's@allce.com YouTube it's on the YouTube channel. I just made a pretty link so it was easier for y' all to find it, but you can learn more in depth about different types. I do have one on there on. I don't remember exactly what it's called, but it's on meditation and then we have one on nutrition, one on sleep, and something else I can't remember at the moment. But you know, if these areas interest you or you think they might interest your clients, you know, we've talked about some different group activities that you can use as well as individual things. And they may even enjoy watching the videos when they're at home or whatever. So are there any questions? All right, everybody. Well, thank you for being here today. And now on Thursday, we're going to talk about spiritual interventions for depression. And we're really talking about spirituality in general and a sense of connectedness, meaning and purpose and talking about how we can harness that to help clients develop psychological flexibility and purposeful action. So alrighty everybody, have a great day and I will see you on Thursday. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube. If you want to attend and participate in our live webinars with Dr. Snipes, you can subscribe at. 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