Cedar Blog

The Five Pillars of Mental Health


Being a hospice social worker as well as a therapist, I often consult caregivers. Those amazing individuals spend countless hours cleaning, feeding, comforting, and worrying about their loved ones. Often, as we all do, they forget themselves as part of the team that needs help, so we end up talking about that obviously important but completely neglected task of self-care. Below are five questions that I have found are the most effective for anyone who needs to maintain their emotional stability.

  1. How are you eating? Rather than the question “Are you eating healthy food,” this open-ended question can lead to discussions not only the types of food, but the frequency and intensity of eating. Someone who is struggling with emotions may lose their appetite, until they eat too much too fast, just to check the box. If you eat emotionally, then you may find that you’re eating more frequently than usual. Either way, finding a balanced way to eat healthy food impacts your mental health. In 2020, one of many studies validated the association of healthy diet with better mood. From that study, the graphic below describes how diet is associated with social factors, biology, and behaviors.
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2. Do you exercise? This question may bring to mind long, sweaty routines coupled with self-loathing and guilt. It doesn’t have to be that way! “Exercise” in this context is not for a Hollywood beach body, but rather for mental health. The National Institute of Health, as early as the 1980s, identified over 1,000 studies that have linked activity with improved mental health. More recently, psychology and neurological textbooks link simple activity, such as regular easy walks, with combatting more complex psychoses while a sedentary lifestyle is highly correlated with poor mental health.

3. How are you sleeping? Sleep affect so much of our day-to-day lives, and is often neglected. I had a supervisor tell me once that it just takes 3 days of no sleep to begin hallucinating “shadow people.” That’s scary stuff, and yet some people skirt that line and expect things to be OK. Watch this talk at Google by the neuroscientist Matthew Walker for some great sleepy information!

4. What are you creating? When we create, we fire off positive neurotransmitters that tell us “good job!” Besides feeling good, it’s good for you! Doing something as simple as writing down ideas can provide brain-boosting effects, such as reducing the risk of dementia. In one study, it was also been found to improve the immune system of those infected with HIV!

5. Who is on your team? This question assesses the supportive relationships in your life. Although not strictly evidence-based and peer-reviewed, I really like this video. In the light of addiction, that video emphasizes the value of and need for human relationships, but it really is translatable to many other realms in our lives. As humans, we need attachments and when we foster toxic relationships, our yearning may turn towards substitutes. Fracine Shapiro stated in her book “Getting Past your Past”, “Unfortunately, when we try to stuff down our emotions, they often come out sideways.”

  • Eating
  • Sleeping
  • Exercise
  • Doing something creative
  • Fostering supportive relationships

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