Expert reports success in improving depression, resilience with wellness intervention

LAS VEGAS — Both patients and physicians can benefit from a validated wellness intervention, Saundra Jain, MD, PsyD, LPC, from the University of Texas at Austin shared here at the Clinician Wellness Preconference at the Cardiometabolic Risk Summit.

"It's a good way to take good intentions and knowledge and put them into practice," Jain said.

Noting that about 400 physicians commit suicide each year, she stressed the need for a more intense focus on wellness. Jain also pointed out that wellness is linked to quality of care and that it's important to model wellness for patients.

"Physicians should walk the walk rather than talk the talk," she said.

Jain discussed a wellness intervention that she helped to develop — Wellness Interventions for Life's Demands (WILD 5 Wellness). The five tenants of the program are exercise, sleep, mindfulness meditation, nutrition and social connectedness, she said.

Exercise

Jain cited research that demonstrated an association between hippocampal volume and fitness. Exercise matters, she said, because the hippocampus regulates memory and emotional wellness.

Mindfulness

Similarly, other research has linked meditation to a positive impact on brain structure. An 8-week intervention where participants practiced mindful meditation was found to increase grey matter in in the brain, she said.

Insomnia

"Sleep is a predictor for both mental and physical conditions," Jain said. "Everyone complains about sleep."

A lack of sleep can lead to issues such as anxiety, depression, headaches and myocardial infarction, she noted.

Social groups

Maintenance of an active social life can be protective against relapse in depression, Jain said. She noted a study that found that if participants were members of three social groups, their risk of relapse decreased by 63%.

Nutrition

Food choices matter, Jain said, reciting the cliché 'we are what we eat.' A review of 304 studies demonstrated that some food and beverage choices, such as red meat, processed meat and sugary beverages, were not protective of mental health. However, diet choices similar to the Mediterranean diet — fish, fruits, vegetables, whole grains, legumes, nuts and seeds — were beneficial.

The intervention

"Here's the challenge: we know all five elements are effective — they work in terms of enriching wellness," Jain said. "The problem is lack of adherence. When we created this program, we wanted to create wellness intervention that was simple, prescriptive and trackable."

The 30-day intervention consists of specific expectations:

exercise 30 minutes each day at least at moderate intensity;
practice 10 to 15 minutes of mindfulness each day;
implement 4 out of 6 designated pro-sleep practices, such as avoiding electronic activities for 90 minutes before bedtime, not drinking caffeinated drinks after noon and eliminating ambient light;
text or call at least two family members or friends or friends each day; and
log daily food and beverage consumption.

Jain said the most common challenge for patients was the feeling of wanting to quit because their participation wasn't perfect. She told physicians that "perfection is not the goal — do your best to practice daily."

Results

The average adherence was 17 to 21 days, Jain reported. In addition, the intervention led to improvement in mental health, pain and community scores for depression, sleep quality, happiness, enthusiasm, resilience and optimism.

Physicians interested in trying the intervention themselves or providing it to their patients can find resources at www.wild5resources.com. – by Chelsea Frajerman Pardes

Disclosure: Jain reported consulting for Lilly, Otsuka and Pamlab.

Reference:

Jain S. Presented at: Cardiometabolic Risk Summit Fall Pre-Conference; Oct. 13, 2016; Las Vegas.