Thrive

What is Lifestyle Medicine? 

The American College of Lifestyle Medicine (ACLM) was developed in 2004 to support healthcare workers who saw the value in preventative care and wanted to help patients recover from chronic illnesses without medication whenever possible. The six pillars of Lifestyle Medicine (LM) are sleep, nutrition, movement, limited drug and alcohol use, relaxation, and connection. There’s a great deal of research supporting the link between the six pillars of LM and important measures of health; everything from immune functioning, metabolic disorders, cancer, cardiovascular disease, and mental health is shaped by these behaviors. 

A variety of healthcare professionals can pursue board certification in LM - physicians, nurses, psychologists, and nutritionists to name a few.   Understandably, each discipline approaches LM a little differently. As psychologists, we naturally prioritize the emotional and cognitive gains a person can experience when lifestyle variables are relatively balanced. For example, we know that maintaining a healthy sleep-wake schedule can decrease anxiety and depression while simultaneously improving learning, memory, and processing speed. Another example is that being aware of the low risk drinking guidelines put forth by the NIAAA (National Institute on Alcohol Abuse and Alcoholism) can help prevent the development of alcohol use disorders. Obviously the remaining pillars - nutrition, exercise, relaxation, and connection are all related to mental health as well. More than anything, we emphasize LM because, regardless of a client’s presenting concern, we view these behaviors as the foundation for lasting change. 

What is Positive Psychology? 

Related to Lifestyle Medicine (LM) is the discipline of Positive Psychology (PP). This area of psychology was developed by Martin Seligman in the 1960s. Seligman’s intention was to apply the principles of psychology to the promotion of wellness, not merely to the treatment of illness. In other words, he suggested that people without current mental health diagnoses could benefit from the science of psychology. PP stems from the work of Abraham Maslow who suggested that human beings have a hierarchy of needs ranging from physical safety to self-actualization. That is, after basic needs have been met, many humans long for personal growth and a  heightened sense of mastery and meaning. The five pillars of PP are: positive emotion, engagement, relationships, meaning, and accomplishment. The acronym PERMA is often used to discuss them collectively. 

As is the case with Lifestyle Medicine, there’s a significant amount of research highlighting the connection between the pillars of Positive Psychology to a person’s overall sense of well-being. For example, individuals who report more engagement in life are better protected from depression and anxiety, and being encouraged to engage in life can help a person recover from depression and anxiety more quickly. Not only are psychologists the professionals who conceptualized and continue to research PERMA,  they have the skills to help clients work through internal barriers to change (i.e. low self-esteem, difficulty setting boundaries), and they are aware of interventions that promote this type of growth in their clients’ lives. 

I don’t think I have a mental health disorder, but I desperately need to make some lifestyle changes. I just can’t seem to do it. Can you help? 

Yes. As you can tell, we genuinely care about these issues and we’d love to help. If you’ve consistently had trouble making important lifestyle changes on your own, completing a mental health assessment is an appropriate first step. This allows us to determine if undiagnosed mental health concerns are getting in the way. If so, we can make treatment recommendations that address both - the mental health issue(s)  and the behavior(s) you’re trying to change. 

Why is this type of change so difficult?  

Maintaining balance in these areas is a struggle for us all.  In fact, it’s rare for any one person to have all areas in balance on a consistent basis. More often than not, we’re able to find our way back to a healthy path. However, there are times when change feels more difficult.  

When change feels harder than it did before, it could mean a few things. First, it could indicate the presence of a mental health disorder. For example, unhealthy drinking may have crossed the threshold into a substance use disorder. Likewise, persistent tension and difficulty relaxing may point to an anxiety disorder. If so, these concerns are highly treatable; therapy and other options can help.

Second, change may be more difficult because your life has changed in important ways. It’s easier to make lifestyle adjustments when work, relationships, and other areas of life feel balanced. Becoming a parent, taking on more responsibilities at work, going through a divorce, and moving to a new city are a few examples that can knock a person off the path of healthy living. Sometimes a person simply needs help adjusting their goals and strategies to account for a new stage of life. Reaching out for support can help a person get back on track faster and prevent a mild issue from turning into a larger concern down the road. 

Finally, finding balance may be more difficult because you have mixed thoughts and feelings about change. In other words, the culprit may be that you’re human. You’d like to change, but part of you feels pretty comfortable where you are. For example, you might want to go to bed earlier, but you feel like staying up late is the only time to relax (we see you, new parents). Even in this scenario, talking with a mental health professional might help. If you genuinely need to change some aspect of your life to preserve your health or relationships but you can’t find the motivation or you don’t know where to start, a therapist trained in motivational interviewing and systems thinking can help. 

It’s worth pointing out that there are times when talking with a mental health professional results in greater acceptance that things are actually fine as they are. This is particularly true for high achievers and/or perfectionistic clients. When it comes to wellness, the pillars mentioned on this page are guide posts, not finish lines. Sometimes making peace with that is the most helpful change of all. 

Why doesn’t my physician talk with me about this? 

In a traditional medical setting there are a few hurdles that get in the way. First, these behaviors are actually rarely prescribed by physicians because they’re not reimbursed by most health insurance companies. Second, most physicians are allotted only 20 minutes per visit leaving them little time to discuss lifestyle variables with their patients. Third, physicians very understandably don’t have the background or training to help patients identify and overcome psychological barriers to change. This point is especially important because we all have a general sense of what we “should” do. Most barriers to change are psychological. Compared to physicians, psychologists typically don’t have these hurdles.  We often work outside of managed care, we meet with clients for an hour or whatever length of time makes sense, and a central part of our profession is helping clients work through psychological barriers to change. Come see us. We’d love to help!