A Therapist Reacts

By Caitlin Sutter, MSW

For this month’s A Therapist Reacts, I wanted an all-encompassing book that talked through some of the basic tenets of mental health coping and what differences they can make in daily living. “Why Had Nobody Told Me This Before?” by Dr. Julie Smith was just the book that I needed. It is not overcomplicated or too abstract. I found that it could be referenced by anyone throughout the year when problems in living arise. Since we were in a gloomy February, “On Dark Places'”, seemed to be the most prevalent issue that a lot of my clients were dealing with at the time. The sleep, nutrition, and human connection sections are often conversations that I have with my own client’s and their support systems.

The number one thing I preach to adolescent clients and their parents is the importance of sleep. Dr. Julie Smith also highlights this as an effective preventative and coping measure for those struggling with apathy or depressive symptoms. “When you haven’t had enough sleep, everything feels ten times harder. Sleep has a profound effect on every aspect of your wellbeing, so if you think your sleep is not as good as it could be it is well worth your time and effort to try improving it” (Smith, 2022). I always get asked, but how much sleep for my teen is enough? I always reference medical professionals! The National Heart, Lung, and Blood Institute recommends for teens aged thirteen to eighteen to get 8 to 10 hours of sleep a night and adults to get more than 7 hours of sleep a night (National Heart, Lung, and Blood Institute, 2022). Some coping techniques that I recommend are DBT sleep hygiene skills as well as establishing routine bedtimes as the most effective and supportive sleep coping skills.

The second basic that Dr. Smith discusses is nutrition. As we all know and have been taught, what we put in our bodies is the fuel for not only what we have to do during the day but also for how we feel. Research shows that “improvements in nutrition can have large benefits for depressive symptoms (Jacka et al., 2017) and making positive changes to how we eat might help prevent depression as we age (Sanchez-Villegas et al., 2013). What diet works best? A study found that “the traditional Mediterranean diet shows the largest and strongest evidence base for mental health benefits, but also the Norwegian, Japanese, and Anglo-Saxon diets as well (Jacka, 2019)” (Smith, 2022). Dr. Smith mentions that it is imperative to focus on small incremental changes to make healthy choices stick. “It is helpful to ask ourselves on a regular basis, ‘what is one small change I could put in place today that would improve my nutritional intake?” (Smith, 2022).

The last basic that I particularly loved is the importance of human connection. In my own practice, a lot of my teens state that they often self-isolate when they are feeling depressed, apathetic, or even suicidal. Dr. Smith states that “taking some time to be alone can be re-energizing and recharging but it can also very easily become a downward spiral of rumination and self-loathing that feeds depression and keeps it going” (Smith, 2022). She cites that, “nurturing good quality relationships is one of the most powerful tools we have in maintaining good mental health throughout the life span” (Waldinger & Schultz, 2010). Parents often ask me for recommendations on how to have their children reconnect in in-person relationships that are healthy and meaningful. Engaging in after-school activity, school clubs, hanging out or Face Timing friends, and even a phone call to a friend has been some chosen methods by teen clients. Children need structure and including social interaction is an important facet of any mental health routine.

Overall, this book is helpful and insightful. For this article I focused on some of the well-known basics (sleep, human connection, and nutrition), but there are other important coping strategies and skills that were brought up in the various sections of this book. Dr. Smith does a wonderful job at chunking big issues down into small swallowable chunks and exploring coping techniques for each chunk. As a therapist, I highly recommend this book for any client and any support person for someone who is struggling with their mental health. Five out of five stars!

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References

Jacka, F.N.., et al. (2017), “A randomized controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial)’, BMC Medicine, 15 (1), 23.

Jacka, F.N. (2019), Brain Changer, London: Yellow Kite.

National Heart, Lung, and Blood Institute. (2022). How Much Sleep Is Enough? Retrieved from National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov/health/sleep/how-much-sleep

Sanchez-Villegas, A., et al. (2013) “Mediterranean dietary pattern and depression: the PREDIMED randomized trial’, BMC Medicine, 11, 208.

Smith, J. (2022). On Dark Places: How to Get the Basics Right. In J. Smith, Why Has Nobody Told Me This Before? (pp. 53-64). HarperOne.

Waldiner, R., & Schulz, M.S. (2010), ‘What’s Love Got to Do With It?: Social Functioning, Perceived Health, and Daily Happiness in Married Octogenarians’, Psychology and Aging, 25 (2), 422-31.