When discussing the possibility of medication with my clients, I emphasize that they have a great deal of control over the necessity of medications with what I call, “The Big Five.” The necessity for and the amount of medication required to treat just about any psychological challenge are greatly effected by: Diet, Exercise, Sleep, Mindfulness, and Connection. The first three most folks know that adjustments to them can have a big effect on their health. The fourth, Mindfulness, is a general term of the practice of being aware of thoughts, feelings, body sensations, and surroundings in the present moment. The fifth, Connection, refers to interacting with people and things that have meaning.

I want to address the biggest payoff activities in each of these areas that can have huge effects on mental, emotional, and physical health (and the necessity for medications). They do not have to be big shifts – small shifts in any of these areas still provide great benefits.

Let’s start with Mindfulness. This can be a challenging practice in our fast-paced, action oriented lives. Any mindfulness activity actively reduces the level of stress hormones in our bodies. Two simple, high-payoff activities for mindfulness both have to do with breathing. First, breathe deeply two or three times, a few times per day. Many of my clients set one of their electronic devices to remind them to breathe during the day. “Deep breath” means to breathe deeply enough to move your stomach out. By moving your diaphragm, you release endorphins, our body’s natural “feel good” chemicals. Of course, you are also getting more oxygen. This activity alone could add 2 – 3 years to your life! The second activity or mindfulness I invite most of my clients to practice is a daily round or two of 10 x 10 breathing. I do this every night when I go to bed. I lay down on my back comfortably and in nice, easy deep breaths, I breathe in to a count of 10 and then breathe out a count of 10. Vary the speed of your counting to match your easy breaths. Do ten of these breaths. If done regularly, this practice trains your body to relax when you breathe deeply – very helpful before that big meeting or while you are sitting in traffic. These two breathing practices together could add 5 – 8 years to your life!

Turning to the four other areas, let’s talk about sleep. Without enough sleep, most systems of the body are compromised. Everyone needs between 7 – 9 hours of sleep. The biggest payoff activity in this area is to make sure you do so. That might mean shutting off or silencing your various screens or heading to bed earlier.  When I received a Fitbit for Christmas and started tracking my sleep, I could not kid myself anymore: I was averaging less that 6 hours per night. I decided to start going to bed earlier very gradually. Over that span of several months I added more that 2 hours sleep to my average.

With regard to diet, there is a huge amount of data supporting a shift towards non-processed, whole fruits, vegetables, and seeds along with meats that come from “free range” animals raised with no hormones or antibiotics. There are many, many apps that can help track food intake and exercise. I use LoseIt. Even if you don’t lose weight, changes towards the above suggestions can make a big difference. Of course, those of you who are overweight would benefit from losing some of that extra poundage. Another huge payoff activity is to make sure you get enough water – most of us do not drink enough and water is required for all of our body functions to work properly. Ask your doctor or do some research on what is the right amount for you.

Exercise: For typical adults, medium to rigorous activity for 30 – 45 minutes, 3 – 5 times per week would be considered very healthy. That kind of activity might seem daunting for some people. What I encourage my more sedentary clients to do is simply to do more exercise than they have in the past. This might mean beginning with walking around the block a few times per week, taking the stairs at work, or parking a distance from your destination. The point is to start with SOME exercise and gradually build up.

Connection: Many people tend to isolate when they are feeling poorly about themselves. Humans are a social animal, meaning we actually need interaction with others for our wellbeing. In a larger sense, connection with anything that is meaningful to us has that effect: interacting with those we love, walking in nature, listening to music, creating or experiencing art, dancing – whatever has meaning to us. Purposely arranging our lives to regularly bring in more of this connection will reduce the production of stress hormones and help remind us of what is important.

Generally, none of these suggestions are a big surprise to most people. Sometimes I have to help my clients overcome negative beliefs about themselves before they can start making consistently healthier choices. I would hope that the prospect of minimizing or eliminating the need for psychotropic medicines might be an added incentive to choose a few of these high payoff activities for your health. Good luck!