By Ryan Hamann, clinician, M. Psych. Sc.
So often the conversations about mental health revolve around how to overcome specific dysfunctions of behavior and cognition – depression, anxiety, phobias, obsessions, etc. Just like we wouldn’t see a mechanic when our car is in perfect working order or a surgeon when we are healthy, therapists are often far from our minds in times of a positive mental state. Mental health, though, is more than just living in the absence of disorders. Thinking about the ways in which we conduct ourselves in our day-to-day lives can make a tremendous difference to our overall well-being and quality of life.
What is self-care?
Self-care refers to the intentional actions and lifestyle choices that we make to improve our mental well-being. Many of these actions can perform as preventative measures against future problems, while others are focused on mindfully increasing our happiness and productivity here and now.
All this is not to say that self-care measures cannot be employed while deep in the thrall of some of life’s most troubling times. While self-care practices alone don’t replace the need for specific interventions that alleviate particular disorders, they will, to some degree, improve the situations in which we find ourselves when dealing with those disorders.
Activities of daily living
To improve our well-being, we must start with the most basic aspects of our lives: the things that we in the industry of healthcare call the activities of daily living (ADLs). These are the daily activities that most people perform when not otherwise prohibited by a particular handicap. This includes self-feeding, ambulatory mobility, hygiene, and more. It might be tiresome to be told to get enough sleep, eat our vegetables, and sit up straight, but there are mental health benefits to being mindful about how these ADLs are performed.
Sleep is very easy to sacrifice in service of time spent performing our conscious activities. I know, there’s homework to do or a Civilization game going and, dammit, Gandhi can’t be allowed to take that resource-rich archipelago. Sleep is paramount to our well-being, though, and is the first stop on our tour of self-care.
Studies have shown that getting too little sleep impairs our memory and cognitive functions and can lead to decreased concentration ability. On a microscopic level, sleep gives our cells an opportunity to replenish proteins that are depleted during the day and allows our brain’s neurons to undergo repairs. In a very real, physical way, a lack of sleep prevents our bodies from rejuvenating itself after the wear and tear of daily life. Eventually, without sleep, our cells may start to break down, we may develop unstable moods, and our immune systems may be dangerously underequipped.
It is thought that memories are consolidated during sleep, meaning that those who get an appropriate amount of sleep will have better memory, improving our efficiency and effectiveness in all areas of life. When we get enough sleep, our circadian rhythms will be balanced, we will be more resistant to disease, and we will, overall, be happier.
One of the ways in which I conceptualize mental well-being is that our brains have a certain amount of energy – our cognitive resources – that we require to function. All of life’s activities draw from this storehouse of energy. Some activities, like eating a pizza, require very little energy. Unexpected activities that require quick thought and improvisation require a lot of energy. Chronic mental disorders, such as depression, anxiety, and Obsessive Compulsive Disorder, draw heavily from this mental reserve at all times, meaning that, while we’re depressed, we only have 20 or 30 percent of the energy we would otherwise have to perform all the rest of life’s activities, which is why performing even the most basic of life’s ADLs can be so tiring. Even when we’re not struggling with a particular disorder, though, our mental storehouses must be refilled so we are operating effectively instead of crawling through life on 2 percent battery life. Sleep is the only thing that refills this energy—it is absolutely irreplaceable. To be clear, caffeine is not a replacement for sleep, and treating it as such will have long-term physical and mental consequences.
In much the same way in which sleep refills our supply of mental energy, so too does eating proper foods. As inconvenient as it might be, our bodies are biochemical machines, and they require the consumption of fuel in order to operate. Food gives our cells the energy and resources that they need to move our muscles, send messages throughout our nervous systems, and support higher cognitive abilities within our brains. Eating better food increases our physical well-being. Our mind and body have constant feedback cycles, and an unhealthy body will initiate negative feedback with the brain, eventually lessening happiness.
On top of the essentials, we should be mindful of our grooming, to the extent to which we are able. Good hygiene protects us from harmful bacteria and viruses. Presenting ourselves well can not only increase our self-esteem but also make others trust us more, smoothing out potential social difficulties. Again, many aspects of self-grooming, hygiene, and appearance are at the luxury of time, resources, and ability which many do not have an abundance of, but regardless of the situation, taking whatever measures are possible to be clean and neat will increase overall happiness.
Though we toss around words like “introvert” and “extrovert” to explain how much we want or need social interactions, everyone does need some level of social exposure. This can be easy to forget or neglect, but it should be considered a need as basic as nutrition and hygiene. Whether it is with close friends or brief interactions with strangers at the store, some level of social interaction is important.
Interaction with others grounds much of our concept of self. We formulate many of our personality aspects, opinions, thoughts, and worldviews based on what we learn from other people, and we should constantly be in a state of expanding this experiential knowledge.
Make intentional time to go out with others. Video games aren’t necessarily isolating. Couch multiplayer can make for great shared experiences. Some of my favorite memories with friends have been playing shows in Rock Band 2, protecting the city in Earth Defense Force 2017, or going slappers-only in GoldenEye. Likewise, online multiplayer games can be terrific tools for connecting friends separated by great distances.
Whether video games are involved or not, though, it is important to have face-to-face time with friends or loved ones. Making intentional time to go out with friends strengthens our support network, gives us the opportunity for vital reality-testing, and gives us exposure to new ideas and opinions. Even the most “lone wolf” gamer needs the occasional visit.
I will be the first to say that I have not been blessed with an immense enjoyment of exercise. I am not competitive enough to enjoy sports, and I have been lucky enough to never have a health scare that would set exercise at the top of my to-do list. Regardless of our levels of motivation, though, exercise is key to physical and mental well-being. Sometimes we have to be a bit sneaky to find the kind of motivation that we require.
If there is one thing that I have an unexplainable fascination with in video games, it is games’ number dumps. I love the statistics and quantitative information that games give me throughout my play experience. Whether I’m looking at my total kills in Vanquish or watching my game’s total coin counter rise in New Super Mario Bros. 2, watching these otherwise meaningless metrics increase adds a sense of permanence to even the most mundane of actions we perform in games. Is it important how many footsteps my character has taken in this RPG? Not at all. Is it an interesting number that I will excitedly check every time? Absolutely!
For me and my weirdly number-obsessed brain, wearing a fitness tracker has been my way into physical activity. We gamers are achievement-driven folk, and exercise can work against this state of mind. Unless we are driven by weight loss or muscle growth, it’s hard to quantify our exercise patterns, but my Fitbit (one of many brands of wearable fitness trackers) catalogues all of the numbers about my physical performance that I could ever want to see and regularly rewards me for hitting certain milestones. Perhaps even more intelligently, Nintendo’s Wii Fit U fitness tracker incorporates information from the pedometer into the game itself, allowing the exercise in and out of the game’s purview to be reflected in its impressive array of statistical fitness information.
Follow your interests and find something that motivates you. Be creative. If exercise is an insufferable discipline, find a way into it that you genuinely care about and enjoy.
Goals and schedules
Sometimes, the monotony of life can be just as dangerous as times of chaos. Life is hard, even when things are “easy”. We’ve become experts at waking up, taking a shower, drinking coffee, going to work, buying food at the grocery market, eating dinner, watching TV, and going back to sleep. The schedule is predictable, and in being predictable, it is safe. But it is also without adventure.
It is easy to slip into depression when things get boring. What I find keeps things interesting for me is always having something to look forward to. Even little things, like going to a nice dinner on the weekend, can be enough to make the week interesting and memorable. I, personally, like to look forward to new video game releases every couple of months or so (having Hyrule Warriors Legends, Dark Souls III, and No Man’s Sky on the horizon makes the future seem exciting). Or maybe your year can be punctuated by events you’re looking forward to (GDC, PAX, vacations, cultural festivals near home).
Set personal goals for yourself. As I have mentioned before, we gamers tend to be very achievement-oriented. We want to make progress. We want to accomplish feats. We can build this into our lives by setting goals for ourselves and making sure that those goals have deadlines. Physical fitness goals, writing goals, even goals working towards making it through our Steam backlogs! Always have something that you’re working towards, and monitor your progress. Be proud of yourself and the progress that you are making.
Finally, make a schedule for yourself. Sometimes, this is the only way that we can achieve our goals. Even the busiest of us will be surprised at the minutes that we can wring out of our day if we’re intentional about our scheduling. Plan ahead, making concrete lists (with detailed steps) of everything you need to accomplish, and make time for yourself.
Preparing for the bad times
If you are reading this in a time of health and happiness, you have the luxury of getting the upper hand on times of despair in the future. Bad times are inevitable. They happen to everyone. Anxiety, depression, and anger are universal. We can take steps to prepare when the going is good, though, and be ready to really kick ass when depression comes knocking again.
I can’t give you those steps – a clinician you work with in your own life can. That said, here are a few common-sense ideas for how to approach this kind of preparation.
First and most importantly, know yourself. Explore your own mind, or work with a friend, therapist or mentor to learn more about your own mind. In times of war, the winner is the one who better knows the battlefield.
You can learn what triggers your emotional responses. When you get angry, you might make a note of what makes you angry, and do some real soul-searching as to why it makes you angry. When something makes you anxious, you might identify it and think about why it causes you such worry. If we know ourselves, we can be prepared for the times when we don’t have the mental energy to deal with life’s annoyances and frustrations.
If you have a propensity to hurt others or a history of suicidal thoughts when angry or depressed, come up with a safety plan before you find yourself in that bad place again. Involve a clinician in the process – they will be able to provide you with advice for how best to prevent a crisis. If you have a friend you can trust, you may want to provide them with any weapons or excess medications that you shouldn’t have around the house in bad times. There is no shame in this. It does not make you weak. It makes you smart.
Understand your triggers and warning signs. What things set you off, and how can you tell when you are beginning to get upset? Are there specific times of the day that are harder for you than others? Times of the year? The better you know yourself, the better you’ll be able to fight the unpleasantness in the future.
Games that promote good self-care
There are many games that model routines and offer goals you’d find in real life, and these can be of great help. One that I’ve found helpful is The Sims.
Self-care can be an impossibly abstract idea at times. The consequences of poor self-care can take days or weeks to really settle in, so it can be difficult to tie together cause and effect. Setting schedules and goals for ourselves can be difficult. Just like basketball players visualizing themselves sinking the perfect three-pointer, games like The Sims can actually help us think in a goal-oriented way.
In my experience, The Sims gives some great feedback about the consequences of our characters’ actions. The unbathed Sim is encircled by flies. The hobbyist painter Sim increases her artistry meter each time that she sits down to paint. It is readable and understandable when the Sim will “level up” in strength or intelligence.
Even though real life doesn’t necessarily work this way, it can serve as a helpful analogue. Anyone who has wanted a buff Sim knows how important it is to make time to work out after work. Perhaps it’s just me, but I become more conscientious of the choices I make in my own life after playing The Sims.
(It may be better to look at games like The Sims rather than games like Animal Crossing which, though I enjoy the series immensely, lends itself more to performing obsessive loops of activities to achieve external goals rather than The Sims’ more self-motivated goal-setting).
I’ve also found games like Nintendogs helpful. Sometimes the easiest way to learn to take care of ourselves is to be responsible for someone or something else. Nintendogs and similar titles can be easier (and cleaner) than owning a real pet, but some of those same lessons can still be learned.