4 Pillars of Good Mental Health


Psychiatric Times asked integrative psychiatrist James Lake, MD, for insights and advice for patients to reduce stress and take care of their mental health on a day to day basis.

Psychiatric Times asked integrative psychiatrist James Lake, MD, for insights and advice for patients to reduce stress and take care of their mental health on a day to day basis, especially important now when life seems to be in upheaval for so many. It is of utmost importance to focus on improving lifestyle factors, which may then translate into improved general mental health, and more resilience in the face of stress.

Dr Lake talks about 4 pillars of mental health and health: getting enough sleep, regular physical activity, healthy nutrition, and a practice addressed at stress management.


In order to optimize your mental well being, a healthy diet with the essential nutrients are vital to healthy brain function. Individuals who have healthy diets tend to function better, feel better, and manage better in the face of stress, whether that is day-to-day work stress, or in this case, the extraordinary unprecedented stress that we are all experiencing. Because of the COVID-19 pandemic a healthy diet that includes fresh fish, vegetables, and grains is essential.

Physical activity

People who engage in regular physical activity tend to feel better and function better. This does not necessarily mean vigorous workouts every day today, but staying active is key. Moderate level of activity might include regular walks (up to 30 minutes or more per day); strength training; using weights; and hiking on the weekends. Nature is always a wonderful way to be active and refreshed, especially during these times of confinement. There is an enormous body of research showing the relationship between regular physical activity and good mental health. In fact, many studies show that individuals who have moderate depression or anxiety or who engage in regular physical activity, including patients who take antidepressants, derive benefit.


A consistent pattern of rest means a patient has enough time to get into deep sleep. This enables one to wake up the next day refreshed, ready go to work or school. Good sleep hygiene entails the things you do from the beginning of your day until the time you go to sleep that night. They will predispose you sleeping better. Try to turn off the television or any other electronics. Students should stop studying at least an hour before going to bed. Don't drink alcohol right before bed and try to avoid it the last few hours of the day. For patients with anxiety disorders, go into a very quiet, peaceful space using gentle yoga or simple mindfulness practice to take their minds off their worries before trying to fall asleep.

People who sleep tend to be more emotionally resilient. In the context of what we are dealing with now, sleep is fundamental to those who are struggling with depression

Stress management

This can be simple or it can be elaborate, depending on your preferences, or religious or spiritual bearings. Listening to music with earbuds, while also engaged in very relaxing breathing practice can be very calming and can significantly lower your baseline anxiety.

Tools for reducing stress include mindfulness, such as meditation, simple yoga styles that are calming and relaxing, and breathing. Some yoga postures can promote improved sleep, and those should be done at night, an hour or so before bed.

During this time of extreme stress, spiritual practices can help relieve anxiety. Because we don't know what the future will bring, it is particularly important and valuable for people to engage in their spiritual work or to get closer to their religious community, whichever is more personally useful. It can provide enormous peace at to delve into, spiritual practice, which might be meditation and even Buddhist prayer, Christianity or Judaism.

There can be enormous power from thinking more deeply in one's spiritual life. and through affiliation with religious community or fellowship for support and for sharing faith with others.

For more by Dr Lake, see A Mental Health Pandemic: The Second Wave of COVID-19.

Dr Lake is a Psychiatrist in private practice in California. His most recent book is An Integrative Paradigm for Mental Health Care: Ideas and Methods Shaping the Future.

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