Rosalind Picard on how to boost mental well-being in 2020
This post was authored by Rosalind W. Picard, Co-Founder and Chief Scientist at Empatica, Founder and Director of the Affective Computing research group at the MIT Media Lab.
Opening a calendar of funny quotes gave me this greeting to the new year, “May your troubles in the coming year last as long as your new year’s resolutions”. I laughed, as the bigger my new year’s resolution, the quicker I usually fail. Most people find behavioral changes to be very hard, and experts have described that even the most successful methods for change typically achieve less than 30% success.
Yet, there are simple practices that do create long-term healthy habits, usually by taking small, frequent steps and making the steps easy.
Where I live in Massachusetts, the ground outside is frozen hard right now, but we regularly make compost from our kitchen leftovers: putting vegetable and fruit peels, nut husks, and coffee grounds into a bin on the counter. Success, in this case, comes from making it super-easy; the countertop bin is handy, and it only occasionally gets emptied into a larger bin right outside the kitchen door. Come spring, we’ll roll it over and dump it in the garden, so that with good soil, we can grow thriving plants, bearing delicious fruit and gorgeous flowers.
So too, in this winter of our bodies, minds, and souls, we can share tips, thus helping one another spot easier ways to prepare good soil in our personal lives, enriching what we can produce in 2020.
Maybe you have been too busy to practice self-care or build healthy habits. While you may have friends planning to run a 10K or half-marathon, your life may feel like a full marathon just living with a complicated and challenging situation. Especially, if you are a caregiver, it is all the more essential that you take care of yourself. If you’ve flown in a commercial plane, you’ll remember that the airline officially commands the adult to put their own oxygen mask on before helping the children with them.
The message is timeless and true: first practice self-care, then you can better help others.
Don’t have the time or money (or desire) to go to a gym? There are a lot of free phone apps you can download with workout routines, starting at beginner levels, some in less than 10 minutes/day, requiring no equipment. Reach out to a friend or family member and suggest that you hold each other accountable to try a 30-day plank workout or another freebie. While you may have a big goal, e.g. to lose twenty pounds, you are more likely to get there if you break it into smaller daily goals where you can succeed, even if all you can fit in is 10 minutes a day of a better habit, like preparing healthier food. You might agree with a buddy that this week you will park further away and walk more briskly, swapping time hunting for a parking space with time spent physically active.
What you choose to do may simply be a small lifestyle tweak, but if you build it into a habit, it can contribute to better health over time.
You are not alone in struggling to find time or motivation. If you can’t work out with a neighbor or friend, try to agree on a brief weekly call to swap tips and encouragement. Make it easy: try someone whom you already talk to at least once a week, share your goal, and ask if they have one. Offer to help them with their goal, if they’ll help you with yours. If this plan fails, that’s OK.
Learn what doesn’t work, and don’t give up: modify your plan until it works.
Prepare for obstacles: what will you do when the ground is icy, the weather is bad, or when a friend brings you an unhealthy 5000-calorie treat? Anticipate what will go wrong, and prepare a back-up plan because obstacles will get in your way. If your buddy doesn’t hold you accountable, tell them to try harder, or pick another buddy if you must. Don’t kick yourself if you have to restart. Put energy into figuring out a way around each obstacle.
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Another tip for success is don’t cut out all the fun things that you enjoy. For example, if you cut out all desserts, then plan some “diet vacation”, special treat days when you can look forward to your favorite snack (maybe splitting it with your buddy). Moderation may be a better goal than stopping something completely. Commit to tweaking your daily habits until you succeed at turning them into healthy habits, but start with little steps. Focus on making it easier to choose healthy options.
Did you know that even 15 minutes a day of jogging can boost your mood?
Yes, even 15 minutes of vigorous activity, less time than it takes to get to the gym, may make a big difference in how you feel.  Even small bouts of exercise can boost a substance in your brain that helps you feel happier (brain-derived neurotrophic factor or BDNF). The most popular anti-depressant medications work by increasing BDNF. 
If you want to try jogging, figure out how to make it easy. Put your clothes and shoes where you’re most likely to change into them at just the time you will jog. Put them in front of the TV if that is what distracts you from jogging. Better, book someone to meet you to jog together at that time, so you don’t make excuses or delay. If you don’t know anybody in your neighborhood, it’s a great excuse to meet them.
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Your body also needs certain nutrients to feel good, some of which are impossible to get when the days are short or you can’t get outside. If you don’t get enough sunshine on your skin, consider drinking Vitamin D fortified milk or taking a Vitamin D capsule. Some studies have shown vitamin D can boost mood and reduce depression.  A lot of people get very low Vitamin D levels from being indoors so much, especially during winter. Taking D helps them feel better.
Hopefully, you aren’t suffering from depression, but it’s very common. If you think that you might be showing early signs of it, like no longer finding much joy in life, make sure to get help: tell a nurse, doctor, coach, pastor, or somebody who can point you to solutions that will make you feel better. The bad news is that it can worsen if you don’t treat it. The good news is with treatment, you can feel happy again.
One of the smartest steps to boost long-term mental and physical health is to build or maintain great sleep habits.
You’ve probably heard the standard advice of “sleep 7-9 hours daily.” However, studies also show that the regularity of your sleep may be influential. Going to bed at about the same time every night, and waking up at about the same time, is associated with great benefits. In a study of 61 college students, irregular sleep and with it, irregular light exposure patterns, were associated with delayed circadian rhythms (going to bed later) and lower grades, while regular sleep was associated with going to bed earlier and getting better grades. 
While most sleep studies show correlation, not causality, their beneficial associations have been replicated many times. For example, an earlier bedtime with more regular sleep timing was associated with a happier mood in a group of 247 students.  Also, more regular sleep timing was related to higher happiness, healthiness, and calmness, measured both mornings and evenings. 
Question: Do you know why they call twelve o’clock at night “midnight?”
Answer: Because it’s the middle of the night.
While some studies suggest that sleeping when it’s dark outside is natural and healthy for people’s circadian rhythms and going to bed earlier is associated with better mood and performance, you may work a night shift or otherwise not be able to follow this “early night schedule”. However, if you already go to bed at the same time (or within roughly an hour) every day, and sleep 7-9 hours total per day, with high sleep efficiency and low sleep fragmentation, then you probably have great sleep: congratulations! If not, then remember that most of these studies are averages over large groups of people. You are unique. There may be something else that works best for you.
If you wear Empatica’s Embrace, it’s easy to monitor features related to your sleep, so you can learn more about what works best for you. Just open the Mate App, and tap on the blue “rest” part of the circular graph.
Your Rest Time is the overall duration of time that you appear to be resting.
Effective Rest is usually shorter because it subtracts the time that you were moving. For example, if your rest time was 10 hours but it included 30 tosses and turns for 1 minute each and one 30 minute interruption where you got out of bed, then your Effective Rest would be 9 hours.
In this figure of the Mate diary, we see a person who said, “I slept more than 7 hours last night, based on the clock time when I turned off the lights vs. when I woke up.” However, her effective sleep time was 6 hours and 47 minutes.
What is Efficiency? It's the Effective Rest divided by the Rest Time. The higher your efficiency, the better. A general rule of thumb is that sleep efficiency of 85% or higher is normal and above 90% is excellent. Insomnia is one possible cause of sleep efficiency below 75%. 
Fragmentation indicates restless movements expressed as a percentage over the rest period. The lower, the better. Fragmentation takes into account arousals and awakenings that cause you to move about and that may disrupt the normal stages and architecture of sleep. Highly fragmented sleep is likely to be less refreshing.
Factors generally associated with worse mood, poorer memory, increased blood pressure, and less attention are high sleep fragmentation and low overall rest time.
Efforts made to fix sleep, even small steps, can thus pay off with significant benefits: both physical and mental.
Not everybody can sleep well all the time. It is normal to go through changes where you have some trouble sleeping. Do you know the number one cause of insomnia? It’s the fear of not being able to fall asleep. Some people lie in bed awake and stress more because they ruminate, “What if I can’t fall asleep?” Stressing about not sleeping is not helpful.
Resolve to NOT stress about this topic!
A stronger approach is to learn a sleep routine that works for you. Keep in mind that sometimes even the best plans will fail, and you have to tweak them and keep trying. If you usually sleep well, then you don’t need to worry if occasionally you have a really bad night. Don’t make it worse by making yourself feel bad about it.
Sleep experts say that healthy sleep is like healthy eating. If you usually eat a healthy diet, then an occasional over-eating binge on a special occasion doesn’t really hurt you. What’s important is to build a healthy long-term routine, so you’ll be resilient and able to bounce back when the bad night comes.
What if you don’t have good sleep or you lie in bed for long periods unable to sleep? These days you can find a lot of free helpful resources and apps to help. Sleep experts typically recommend what’s called “Cognitive Behavioral Therapy for Insomnia” or CBT-I. These apps give you tricks and techniques proven to solve lots of the challenges people face to fix their sleep. Some CBT-I apps also give you access to personal sleep coaches (but you have to pay for those.) The US Government’s Veteran’s Administration has made its CBT-I app available for FREE.
A randomized control trial was conducted with people who had insomnia, where 358 people underwent CBT-I and 300 were exposed to sleep education emails weekly for six weeks. Those who underwent CBT-I improved significantly more both in reducing insomnia and in reducing depressive symptoms.  Thus, fixing your sleep may also make you feel happier.
Whatever you have in mind for 2020, please know that at Empatica we believe every human life has inestimable value.
You are special, and we are grateful that you are uniquely you, no matter how good or bad your habits! We hope that something in this post helps inspire you to take better care of yourself this year. Happy new year, one small step at a time!
Words worth reading
1. Choi, Karmel W., et al. "Assessment of bidirectional relationships between physical activity and depression among adults: a 2-sample mendelian randomization study." JAMA psychiatry 76.4 (2019): 399-408. See this friendly article describing the 15-min Exercise mood boost: https://www.health.harvard.edu/mind-and-mood/more-evidence-that-exercise-can-boost-mood
2. Lee, B. H., & Kim, Y. K. (2010). The roles of BDNF in the pathophysiology of major depression and in antidepressant treatment. Psychiatry investigation, 7(4), 231.
3. Jorde, R., Sneve, M., Figenschau, Y., Svartberg, J., & Waterloo, K. (2008). Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. Journal of internal medicine, 264(6), 599-609. https://www.ncbi.nlm.nih.gov/pubmed/18793245
4. Phillips AJ, Clerx WM, Sano A, Barger LK, Picard RW, Lockley WE, Klerman EB, Czeisler CA, "Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing," Scientific Reports 7, Article number: 3216 (2017). PDF
5. McHill, AW., Barger, L.K., Sano, A., Phillips, A.J., Czeisler, C.A and Klerman, E.B. "Influence of Sleep and Circadian Preference on Exercise and Subjective Mood in College Undergraduates," Sleep2017, June 2017. Abstract
6. Sano A, Phillips AJ, McHill AW, Taylor S, Barger LK, Czeisler CA, Picard RW. "Influence of Weekly Sleep Regularity on Self-Reported Wellbeing," Sleep 2017, June 2017. Abstract
7. Peters, Brandon “How to Improve Your Sleep Efficiency” https://www.verywellhealth.com/sleep-efficiency-3014912; Updated Nov 26, 2019; accessed online Jan 1, 2020.
8. Cheng, P., Luik, A. I., Fellman-Couture, C., Peterson, E., Joseph, C. L., Tallent, G., … & Drake, C. L. (2019). Efficacy of digital CBT for insomnia to reduce depression across demographic groups: a randomized trial. Psychological medicine, 49(3), 491-500. https://www.ncbi.nlm.nih.gov/pubmed/29792241