I observed during my clinical work in various therapeutic units and acute services over the years that patients often described the experience of a “breakdown”. This could be due to a severe bout of depression, or a psychotic episode, for example. This left people feeling very “broken”, as if their lives “scattered into pieces”. One of the therapeutic models we employed to help patients put their life back together, was through an evidence-based model, called “Psychosocial Rehabilitation”. Broadly speaking, this model focuses on helping people to achieve their optimal functioning, through reducing uncomfortable symptoms and increasing their autonomy and social support. This usually took the form of therapeutic groups and family meetings would often be incorporated as well to show them how best to support the affected individual.

Today I would like to share 6 steps anyone can follow to help them on their recovery journey. My approach draws from the following two theoretical frameworks as well:

• Person-centred approach: To always keep the “person” in mind by respecting their unique abilities and strengths, and to focus therapeutic intervention on desirable outcomes.
• Cognitive-behavioural: A skill-based approach to manage arousal and to explore emotions, such as breathing exercises, as well as identifying/distinguishing-, labelling- and rating emotions.

This integrative understanding also touch on important topics such as mental health and wellness, identity, your life’s purpose and meaning, hope and connectedness, as well as self-care and self-acceptance.

It is likely that the information below might not be totally new information, but perhaps serve as a reminder/reinforcement of its value to mental wellbeing.

1. Exercise

Research has shown that exercise can be more effective to improve mental wellbeing than certain medications and other forms of therapy. It can certainly be used as a preventative measure as well to guard against a breakdown. However, exercise does not mean that you have to take out an expensive gym membership and start pumping irons. Exercise can take many forms and it’s about finding what works for you, e.g., dancing/zumba, jogging, or a social activity with friends such as tennis.

In practice we find that people often limit themselves with what they can/cannot do viz. “excuses”. But of course, do what is in your capability and it is best to speak to your doctor first if you are unsure.

2. Sleep

Good quality and quantity of sleep is imperative for one’s recovery journey. Yet, sleep is a problem for many people we see in clinical practice (actually, for most people!), and often precedes a breakdown. Irregular sleeping patterns often precedes or even maintain several mental health challenges. Broadly speaking, we can break this section down into quantity and quality of sleep.

Quantity: It is recommended to get 7-9 hours of sleep per night. However, people regularly have difficulty achieving this, and it seems a lot of it is related to the quality of our sleep.

Quality: Did you get a good night’s rest? Often in today’s society we only start to process our day once we hit the sack, and then our brains are so stimulated that we have difficulty falling asleep. Many of us have TVs in our bedrooms or spend time on social media before going to bed. This touches on the concept of sleep hygiene, which advises that people should be mindful of how they setup their bedroom (so that it’s not an entertainment centre) and wind-down routine. For example, a 10-minute stretch routine followed by a Mindfulness exercise or faith time can help you start to relax and prepare for bed.

A bonus note: Andrew Huberman often speaks about the value of getting early morning sunlight to stimulate your wakefulness state.

3. Nutrition

Although there are various models and debates around the conceptualisation of nutrition, broadly speaking we need to ingest the following 3 sources of food: carbohydrates, fats and protein. It can be helpful to speak to your doctor or a dietitian to advise if your body/diet is in need of specific nutrients or vitamins to help you function optimally.       
We often see people starting a meal plan that might not be sustainable for various reasons. Be sure to choose and stick to something that will work for you (and your household) and won’t break the bank.

The Real Science of Sport also did a fascinating podcast on supplements.

8 Glasses of water a day is recommended and to remember to mostly avoid unhealthy, fatty takeout foods, processed meats and sugary/caffeinated drinks. I have noted that in recent years there has been a big increase in the consumption of cheap energy drinks, that is loaded with sugar and caffein which can affect one’s sleep.

4. No substance use

This might seem obvious, but unfortunately many people indulge in the use of various substances during their recovery journey which can derail the entire process.

Be mindful of legal substances and its effects as well – smoking of cigarettes and drinking alcohol are known culprits to affect physical health, nutrition and sleep.

5. Medication adherence

If you are on medication, especially after a psychiatric admission, it is usually strongly advisable to never skip or stop your medication, unless you have discussed it with your doctor. There are many sad stories, especially from the acute inpatient settings, about patients who stopped their medication after they became better, only to fall sick again and be readmitted shortly after.

Yes, for many people it is a massive burden to take medication every day, and many despises the notion that they will have to use it for the rest of their lives (and to be honest, who wants to, right?). But in many cases it becomes a choice between not using the medication and risk exacerbating your symptoms, or using it and (hopefully) live a fairly stable life. Like a colleague and friend of mine regularly noted: we always have choices – we might not like those choices, but it’s still ours to make.

6. Mindfulness

There’s not much that I can add about Mindfulness, awareness and breathing exercises that has not already been written. We are now aware of its efficacy with reducing and dealing with the anger, depression, anxiety and trauma. The research is quite strong in favour of us all adopting elements of Mindfulness, such as giving “airtime” to our thoughts and feelings with judgement, to be kind to ourselves, and being grateful. There are various apps and YouTube follow-along tutorials out there, so I encourage you to do a bit of your own research to see what resonates with you.