Some people choose medication to treat mental illness simply because it's easier than sticking to an equally effective behavioral plan. Protecting sleep is key to any natural plan to combat stress, anxiety and depression. New research shows that short, moderate-intensity exercise can be beneficial effective in improving and treating major depressive disorder. Sleep, exercise, diet and meditation are the foundation of health and can help anyone, depressed or not, feel better. The purpose of this post is to provide guidance for anyone suffering from fatigue, insomnia, depression, anxiety, stress, burnout, or problems with attention and concentration. The first part discusses behavioral interventions, and the second part focuses more on supplements and over-the-counter treatments. Safety First Please always talk to your doctor if you feel unsafe or have had suicidal thoughts, and of course, don't stop take medications and do not make changes on your own. If your symptoms are enough to impair your ability to work, sleep, or rest, consider seeking professional help. Consistency is the key to everything you do Before we dive into alternatives to taking prescription medications, I would like to emphasize the importance of taking things seriously and following a routine. Too many people promise that they will do something regularly, such as exercise or meditate, and then their intentions fall by the wayside. Be consistent and patient. Whatever you try, do it daily and stick with it for at least a month. Treat these interventions the same way you treat medications—don't skip doses. Enough people end up taking medication because it's easier than sticking to a more natural behavioral plan, which can be equally beneficial. Journaling Our moods tend to leak into the time surrounding the present. If you feel terrible today, you probably think you always have. The opposite is also true. Even patients who have improved with medication tend to believe that they have always felt the way they have. I often ask my patients—at least at the beginning of any treatment—to write down what they feel, what worries them, and how they react to what is happening. The goal is to compare before and after—in your own words. If you're considering any intervention, from medication to meditation, take the time to keep a journal so you can track your progress and see the before and after results in your own records. Mood tracking and/or journaling is a beneficial practice for everyone and makes the process of self-improvement more systematic and less subjective. Writing also really helps you process feelings.Get SleepSleep is the most restorative activity of the brain. Evolution has preserved sleep forever in all plants and animals because it is so important. Our brains store information, recharge neurotransmitters (like serotonin and dopamine), process emotions, and experiment with creative solutions while we sleep. Good sleep leads to better impulse control, making it easier to stop thinking in cycles, falling off emotional cliffs, eating too many potato chips, or doom scrolling until the wee hours of the morning. Nothing, including prescription drugs, works if you don't get enough sleep. I often tell my patients, “If there's no gas in the tank, you won't be able to step on the gas pedal.” Fatigue can also mimic depression, increase anxiety, affect memory, and reduce impulse control. Regular bedtime and wake-up times are importantmeaning. In addition to sleeping in a cool, dark bedroom, turn off screens and all interactive (or overly stimulating) objects at least an hour or two before bed. I advise my patients to “turn off technology at 10,” meaning no screens, computers, text messages, email, or any other electronics before bed. If you can't sleep, read, ideally on paper in a dimly lit room or on a Kindle, but on a Kindle try inverting the colors for white text on a dark background. You want to reduce the amount of light emitted from the screen as much as possible. If you wake up in the middle of the night, make sure your bedroom is cold and you're not too hot. Cold is better for sleep. Try meditation if you can, or relax and visualize your favorite places for 20 minutes. If you can't fall asleep by this time, get out of bed and do something relaxing, such as reading in dim light. Return to bed when you feel sleepy. Don't allow yourself to tense up or toss and turn in bed. Also, don't "reward" insomnia with productive activities at night, such as work or email. If you wake up too early, make sure you don't have sleep apnea, which is often diagnosed in overweight people or those who have had braces in childhood. Patients with sleep apnea often wake up several times during the night and feel quite sleepy during the day, despite getting adequate sleep. Loud, prolonged snoring and pauses in breathing are signs of sleep apnea. Various smartphone apps are available that record your sleep at night and allow you to listen to your own breathing, so you don't have to rely on your bed partner. Exercise Our basic human functions require not only good sleep at night, but also sufficient activity during the day. We're simply not designed to sit at a desk or on the couch all day long. "Vertical time" spent upright and moving, ideally by exercising most days of the week, helps blow off steam and has been shown to improve neurogenesis, as described by the authors of a 2018 paper in Neural Regeneration Research. Neurogenesis involves the necessary growth of new neurons and connections in the brain. Research shows that exercise can improve your mood, reduce anxiety, and improve the quality of your night's sleep. I recommend about 30 minutes of exercise daily, four to five times a week if possible. If you can't speak easily while exercising, know that you're working out quite intensely. Of course, exercise is just as good for the mind as it is for the body. In a study published in Frontiers in Psychology, scientists concluded that exercise “determines positive biological and psychological effects that influence the brain and cognitive function and promote well-being. [Exercise] plays an important role in counteracting normal and pathological aging.” Other investigators agree. A study published this year (2022) in the Journal of Sport and Exercise Psychology suggests that "short bouts" of moderate-intensity exercise appear to be effective in improving mood and treating symptoms of major depressive disorder. "Mediterranean diet" You are what you eat." If you want to be healthy, you must consume healthy foods. Indeed, experts have long known that, unlike high-fat Western diets, eating plans that emphasize consumption of fish, vegetables, and fruits (such as the Mediterranean diet) are associated with a lower risk of depression and depressive symptoms. Many of these healthy foods contain antioxidants, natural chemicals with antidepressant properties. In fact, the authors of an article in Antioxidants (Basel) suggest that future research should consider how