The 5 Pillars of Emotional Self-Help

The 5 Pillars of Emotional Self-Help

Christopher Kolker MD

“I wish I could do something to make things better!”

Regrettably, I’ve heard this sentiment throughout my career. As a primary care physician, I frequently encounter individuals who are struggling with anxiety, depression, or both. These conditions can be overwhelming, leaving people feeling lost in their thoughts and the complexities of their lives. It's important to remember that you're not alone in this.

When you search for ways to manage depression and anxiety, you'll find that standard therapy often involves medications and counseling. These are crucial and should be part of any comprehensive treatment plan. However, many people find that they need more. They need to know that there are other strategies out there, waiting to be discovered.

Self-help is not just an option, it's the third pillar of treatment. These conditions are not passive, and their treatment shouldn’t be either. I encourage my patients to take action. However, I understand that if they knew exactly what to do, they wouldn’t be seeking my guidance in the first place.

As a physician, I aim to assist my patients in structuring their self-help treatment plans. While I may not know them well enough to prescribe specific actions, I can guide them in understanding that they hold more power over their treatment success than they might realize.

Here are the rules I give them: We all have five dimensions of our lives. I ask each patient to change one small, doable thing in each category they are not already doing to improve their mood. Everyone gets to choose what they do.

One more rule:  you don’t get past credit. This means that most people have already tried to do something to help them with anxiety or depression. But whatever they’re doing must not be enough, or they wouldn’t be in my office with this issue. Each patient must do something new, even if their prior attempts fit squarely into one of the categories.

Everyone’s life can be divided into five categories: mental, which includes thoughts and feelings; physical, which includes your body’s health; spiritual, which includes how you relate to God or your morals and values; social, which includes your interactions with others; and environmental. This can include the information you receive from others and the physical environment surrounding you.

Therefore, each patient must do one small thing to improve their mood in each category. Here are some examples in each category. Remember, everyone gets to choose what they want to do.

Mental- This would include guided imagery, where one imagines oneself at ease and meditation. YouTube is beneficial because it shows people different meditative techniques.  However, mental work can also be as simple as journaling thoughts and feelings a couple of times a day onto paper to get those repetitive thoughts out of the brain.  For journaling to be successful, nobody else must read it so that folks don’t start editing the journal and not writing out their true feelings.

Physical—This means finding something to do to better care for your body. Most think of exercise, but it can also include sleep, yoga, stretching, better nutrition, or getting more sunlight, especially in the winter.

Spiritual—Two tracks can be taken. For those who believe in a more traditional God, this might include starting or expanding their prayer life, reading religious literature, studying more about their own faith, or spiritual meditation. Sometimes, it means stopping some unwanted behaviors that interfere with their spiritual life.

For those who don’t believe in a traditional Judeo-Christian God, I have them perform random acts of kindness. They should start by performing small acts of kindness for people they otherwise would not have done. Once they have done one act, each patient needs to find the next act to do. This keeps their minds away from their issues and teaches them gratitude for those around them.

Social—This can be a deceptively difficult category. I tell patients that this category is simply having fun with somebody else in a constructive way. Sadly, many have forgotten how to have fun! I have seen countless people struggle with this, and I know that joy is no longer a part of their lives. Once they finally have fun, I ask them to find something else. It’s time to build a fun social calendar so they always have something to look forward to.

Environmental- This can also be one of two tracks. For many, it’s more about their physical environment. Some people, especially those suffering from depression, have let things go and need to clean and declutter. In those cases, it is amazing how getting rid of junk can be helpful.

For others, even small things like pictures on the wall can sometimes bring a little bit of joy to somebody who doesn’t have any.  Others respond beautifully to aromatherapy, where their favorite scent greets them when they come home from a hard day’s work.

But this could also be their informational environment.  A classic example:  I have found many patients who watch either MSNBC or Fox News (it doesn’t matter which one) all day long and then wonder why they’re always angry. That’s an easy fix. But during times of depression or anxiety, it’s critical to keep things positive and not feed the negativity. Ensuring that music, shows, movies, and Internet sites are as upbeat as possible is crucial to their treatment.

Even with all this homework, some are so enmeshed in their feelings that all these changes won’t matter.  “Do you think I am a glass of orange juice away from being OK?” one of my more cynical patients asked.  I tell my patients that while these things are necessary to feel better, none are sufficient to help their mood independently.  No, orange juice does not fix all problems.  But if you don’t take care of yourself physically, changing your mood can be nearly impossible.

This process of self-improvement should never truly end. Once a positive change is achieved in one of these categories, the goal is to keep seeking new projects, new changes that are achievable and beneficial in that same category. The battle against anxiety and depression is ongoing, but with these strategies, it can be managed.