Rates of behavioral health conditions continue to increase, especially among young people—reeling from the impacts of social isolation, depression, anxiety and substance (mis)use, and so many other stressors, which were all exacerbated by the global pandemic. These realities underscore the ongoing and growing concern about mental health and wellbeing. Despite all the existing behavioral health supports, services and treatment that exist, there regrettably remains a significant challenge in accessing these services. Factors such as stigma around mental illness, lack of insurance, inadequate coverage, and multiple health related social needs still create barriers in how one can access needed care. These disparities were also highlighted and in many instances exacerbated during the COVID-19 pandemic.
The global pandemic’s impact on behavioral health issues is borne out in the data, for example, a Pew Research Center study revealed that about 25% of adults experienced high levels of anxiety and stress during the pandemic. Similarly, a CDC report showed that more than a third of high school students reported mental health challenges during the pandemic, with a significant percentage feeling sad or hopeless. This trend was notably higher among girls and LGBTQ+ students. As a parents of 2 adolescent boys, my concern for their mental health is matched by 40% of parents who expressed being extremely or very worried about their children struggling with anxiety or depression. (Pew Research Center)
In May 2023, Surgeon General, Dr. Vivek H. Murthy, came out with an Advisory calling attention to loneliness (1) and social isolation (2) as a public health crisis. Research shows that loneliness strongly correlates with poor physical health consequences like premature deaths, increased heart disease, risk of dementia or stroke, as well as mental health issues, like depression and anxiety. Research shows that loneliness has been particularly impactful during the COVID-19 pandemic, especially because of social distancing and isolation, with the added impact of technology and social media, affecting adolescents and young adults more significantly. (3)
These associations suggest a critical need to consider loneliness among the many modifiable risks factors when we are engaging with someone in behavioral health care. Across all age groups, the research has shown that loneliness and isolation increase the risk of depression and anxiety and there is a very strong link between isolation and suicidality. (4)(5)(6)
In that context, as behavioral health professionals, we must begin to pay more attention to loneliness and social isolation as key components in our assessments and treatment planning and incorporate mindfulness and gratitude practices in our approaches.
Mindfulness
mindfulness n. awareness of one’s internal states and surroundings. The concept has been applied to various therapeutic interventions—for example, mindfulness-based cognitive behavior therapy, mindfulness-based stress reduction, and mindfulness meditation—to help people avoid destructive or automatic habits and responses by learning to observe their thoughts, emotions, and other present-moment experiences without judging or reacting to them. |
As mindfulness practices increasingly become recognized as effective approaches in mitigating certain mental health conditions, we are seeing more research on these practices, reflecting a growing interest in mindfulness as a therapeutic tool. When we say mindfulness, we are talking about practices that involve focused attention, meditation, awareness of present moment experiences, and nonjudgmental acceptance of these experiences, helping individuals cope better with stress, anxiety, and depression. The efficacy of mindfulness practices has been proven in multiple studies, highlighting their potential as a complementary approach to more traditional approaches to mental health treatment.
A recent comprehensive meta-analysis of mindfulness practices, which included multiple peer-reviewed articles, found that mindfulness practices were beneficial in reducing symptoms of anxiety and depression; highlighting the correlation between mindfulness and improved mental health outcomes. (7)
For example, mindfulness practices, such as Mindfulness-Based Stress Reduction (MBSR), have shown promise in reducing symptoms of anxiety and depression. (8) MBSR, developed by Jon Kabat-Zinn, is an eight-week program that includes meditation and mindfulness practices, designed to help individuals cope better with stress, anxiety, and depression.
Beyond specific conditions like anxiety and depression, we are seeing that mindfulness practices have broader mental health benefits by emphasizing a state of awareness and presence, which can improve one’s resilience and overall emotional wellbeing.
Gratitude
gratitude n. a sense of thankfulness and happiness in response to receiving a gift, either a tangible benefit (e.g., a present, favor) given by someone or a fortunate happenstance (e.g., a beautiful day). |
Gratitude is a powerful emotion that can significantly affect one’s mental wellbeing and has been associated with increased happiness, life satisfaction, and better physical health. We know that gratitude can aid in coping with difficult emotions and situations and may help to reduce symptoms of depression and anxiety.
Practicing gratitude can take many forms, such as meditation, writing thank-you notes, maintaining a gratitude journal, or even thanking oneself for daily accomplishments. These practices promote a habit of thinking more positively and appreciating the smaller aspects of life and not focusing on the negatives.
Engaging in gratitude practices has been shown to produce immediate and significant improvements in happiness and a reduction in depressive symptoms. Research has consistently demonstrated the positive effects of gratitude practices on mental health; for example, a single act of thoughtful gratitude can increase happiness by 10% and decrease depressive symptoms by 35%. However, these effects tend to diminish over time, emphasizing the importance of continuous practice of gratitude.(9)
A systematic review and meta-analysis of gratitude practices revealed that individuals who utilized gratitude practices experienced not only heightened feelings of gratitude but also better mental health overall. They reported fewer symptoms of anxiety and depression, alongside a more positive mood and emotions, indicating that gratitude practices can serve as a therapeutic complement for treating anxiety and depression.(10)
5 Practical Tips To Incorporating Mindfulness And Gratitude Practices Into Mental Health Treatment
1. Incorporate Mindfulness Meditation Daily: set aside a specific time each day for mindfulness meditation, even 10-15 minutes can be effective.
2. Gratitude Journaling: keep a gratitude journal where you can write down things you are thankful for each day.
3. Mindful Breathing Exercises: incorporate simple breathing exercises that can be practiced anywhere to help center the mind and reduce stress.
4. Set Gratitude Reminders: set daily reminders to pause and reflect on something you are grateful for, fostering a habit of gratitude.
5. Integrate Mindfulness into Daily Activities: practice mindfulness during routine activities like walking, eating, or showering, turning everyday moments into opportunities for mindfulness.
Mindfulness and gratitude practices are emerging as valuable interventions in addressing mental health issues and can be seamlessly integrated into therapy sessions and one’s daily routines. Mindfulness and gratitude practices offer a powerful tool and a promising avenue for support, complementing traditional mental health treatments and have been shown to be beneficial for a wide range of conditions and individuals, including those with subclinical and clinical levels of certain mental health issues.
Over the last several years we have had to navigate complexities in our current world, both globally and nationally, that have been unprecedented. As 2023 winds down and we start to gear up for what lies ahead in 2024, I strongly encourage us all to include mindfulness and gratitude practices in our daily lives not just as a therapeutic tool but as necessary components for our mental wellbeing.
Amidst all the chaos and uncertainty, these practices can offer a moment of peace, a chance to recalibrate, and a reminder of all the good that exists. These can teach us to celebrate even the small moments in life, appreciate the present, cultivate a culture of thankfulness for what we have, and become more empathic. Let us embrace mindfulness and gratitude as essential components of our personal journey towards a holistic approach to living a balanced, mindful, and fulfilling life.
References:
(1) Loneliness: A subjective distressing experience that results from perceived isolation or inadequate meaningful connections.
(2) Social Isolation: Objectively having few social relationships, social roles, group memberships, and infrequent social interaction.
(3) Steen, OD, Ori, APS, Wardenaar, KJ, et al. Loneliness associates strongly with anxiety and depression during the COVID pandemic, especially in men and younger adults. Sci Rep 12, 9517 (2022). https://doi.org/10.1038/s41598-022-13049-9
(4) Mann F, Wang J, Pearce E, et al. Loneliness and the onset of new mental health problems in the general population. Soc Psychiatry Psychiatr Epidemiol. 2022;57(11):2161-2178.
(5) Loades ME, Chatburn E, Higson-Sweeney N, et al. Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19. Journal of the American Academy of Child & Adolescent Psychiatry. 2020;59(11):1218-1239.e1213.
(6) Shaw RJ, Cullen B, Graham N, et al. Living alone, loneliness and lack of emotional support as predictors of suicide and self- harm: A nine-year follow up of the UK Biobank cohort. J Affect Disord. 2021;279:316-323.
(7) Fuming X, Wanling Z, Qian C, et al. The relationship between mindfulness, anxiety and depression during the COVID-19 pandemic: A meta-analysis of correlational studies. Frontiers in Psychology. 2023, Vol 24. doi=10.3389/fpsyg.2023.994205. ISSN=1664-1078
(8) Niazi AK, Niazi SK. Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses. N Am J Med Sci. 2011 Jan;3(1):20-3. doi: 10.4297/najms.2011.320. PMID: 22540058; PMCID: PMC3336928.
(9) Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005 Jul-Aug;60(5):410-21. doi: 10.1037/0003-066X.60.5.410. PMID: 16045394.
(10) Diniz G, Korkes L, Tristão LS, Pelegrini R, Bellodi PL, Bernardo WM. The effects of gratitude interventions: a systematic review and meta-analysis. Einstein (Sao Paulo). 2023 Aug 11;21:eRW0371. doi: 10.31744/einstein_journal/2023RW0371. PMID: 37585888; PMCID: PMC10393216.
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