Posted by Kim White, MD 

 When I meet new patients in my office, the stories and sufferings are as varied as we know life itself to be. During evaluations I hear of the stress and distress, unhappiness and hardships that come together and erode our emotional equilibrium. It becomes very difficult to get through the days comfortably, to manage family needs and job responsibilities. And the first things to fall away when overwhelmed are the basics of self care: sleeping and physical activity. 

 Early in my treatment work, I turn the focus to sleep. Most adults shortchange themselves on sleep - there is simply too much to do in 24 hours, too many tugs at our coat sleeves, too many calls to make or places to be. But sleep is a powerful healing force. Too little sleep will make the healthiest person irritable, anxious, poorly focused, error prone, lethargic, depressed, and overeat. Add sleep deprivation to a mood or anxiety disorder, and mental health is further impaired. 

 The National Sleep Foundation has extensively researched sleep needs of children and adults. Their 2015 healthy sleep guidelines are not surprising: adults (age 18-65 years old) need somewhere between 7 and 9 hours of sleep at night. An average of eight hours for healthy sleep is not just an old wives tale, it is a researched guideline. Period. You probably know yourself well enough over the years to sense where on that spectrum you sit. But take a moment to reevaluate. If you are getting 8 hours of sleep every night and you are still tired the next day, try increasing to 8 1/2 or 9 hours and see if that is really what you need to feel your best. 

 Sleep is free. There are no side effects. Be sure you are getting the sleep hours you need. And if you are not able to sleep, due to insomnia or medical problems, ask your doctor or therapist for some help. There are great cognitive behavioral treatments, sleep hygiene strategies, and for some, sleep medications that make a big difference. 

 My second focus is on physical activity, both for better emotional well being as well as more resilient physical health. The health benefits of exercise are well documented, and include decreased risks of heart disease, diabetes type 2, cancer, bone fractures, cognitive decline, and depression. There is surprising coherence in recent years from researchers on how much exercise is needed to be healthy. The Department of Health and Human Services has issued Physical Activity Guidelines for Americans. The magic number seems to be 150 minutes of exercise spread out over the week. Exercise here includes strong walking, and does not need to be (but can be) higher intensity activities like Soul Cycling or gym workouts. 

   30 minutes of strong walking or other workouts, five times a week is the goal. Or, for my frailer patients, I recommend 20 minutes of walking a day, 10 minutes out, and 10 minutes back home. Most of us can do this. It benefits mental health and improves the resilience and reserve of all organ systems of the body to extend and live a healthier life. If all this sounds daunting, keep in mind that any amount of exercise is better for you than remaining sedentary. 

 No medication or therapy alone can do for the mind (and body) what sufficient sleep and regular moderate exercise can. Take good care of yourself. No one else will do it for you.