"The mind is everything. What you think you become."

Most of my patients over the years have understood that things such as exercise, and better sleep would improve their mental and physical health, but these topics often feel like an afterthought during appointments. I have struggled to make this a more important part of my work with patients, maybe because it feels odd to talk about something other than medication with their psychiatrist. I have found that when I ask about lifestyle factors, people often seem overwhelmed by the prospect of paying attention to such things in their day to day lives.  I have felt this myself. In our busy and ever accelerating culture, taking the time to change your habits can seem impossible and like something you have to figure out all on your own. I have been caring for pregnant and postpartum women now for over a decade, and over the past 6 years, I have had the opportunity to care for these women for longer periods of time, well past the immediate postpartum period and I have noticed some commonalities.

• Medications work most of the time, or some of the time.
• My patients tend to gain weight over time and don't know exactly what to eat
• My patients struggle with sleep
• My patients struggle with balancing the business of their lives with time to care for themselves
• My patients struggle to maintain a regular exercise routine
• My patients struggle to communicate effectively to get the support they need

I know that these issues are not just affecting my patients. In fact, I see these issues everywhere in our culture, it is HARD to do the things that we know will improve our lives. It turns out that improving these factors--sleep, nutrition, exercise, self-care and community--aren't just nice additions to a healthy life; they can be fundamental to our physical and mental health. As this has become more clear to me, I have decided that is my duty as a physician, having given an oath to work to improve the lives of my patients, to try to incorporate this into my day to day care of patients. 

To this end I am expanding my practice to start to include interventions to improve the metabolic health of my patients. I am not going to stop using medications as an intervention, but I want to expand the focus. I am starting by introducing a workshop called Mental Health Foundations: Helping Women Build Sustainable Wellness Habits with a Focus on Sleep, Nutrition, Movement & Self-Care.

Its a mouthful, but what it means is, lets work together to improve our mental health by improving our metabolic health. (Oh yeah, and remember, I'm a psychiatrist, so this isn't going to be a hard-core exercise and diet program. Just a group of normal women trying to make some small changes to improve their mental health together.)