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If you are thinking about making changes to improve your health and happiness in 2019, formulate a realistic plan and begin with small steps, advises the chair of psychiatry and behavioral health at the ���ӽ紫ý School of Medicine.

Too often, Dr. Alison Netski said, people making such resolutions for the new year aim too high, setting goals that can be problematic, not only because they are unrealistically large in scope, but also because no plan has been put in place for achieving the goals.

“Our society places so much value on the new year being a potential reset, so being able to set some small, achievable goals for yourself is a good place to start if you’re thinking of making changes,” said Netski, who specializes in the treatment of adults with a broad range of psychiatric illness, including mood, psychotic, and anxiety disorders.

“What you don’t want to do is make unrealistic resolutions — say, you’re going to quickly lose 40 pounds without any real plan for doing so,” she said. “When you don’t do it, which often happens, you feel like a failure, and instead of feeling better, you end up having a worse self-image.

On the other hand, achieving those smaller goals can have a beneficial impact. “If we can do what we set out to do, we lose the feeling of being powerless, feel better about ourselves.”

With that in mind, Netski spelled out five areas that she said can put you on a path to improved mental health in 2019.

Be purposeful with free time

“When I ask people who aren’t happy with their situations what they would like to do more of, they list things like getting started on a new book, regularly having coffee or lunch with a friend, getting in a bit of exercise,” she said. “They complain that they don’t have enough time.”

Often, however, the real problem is not that they don’t have enough free time, it is how they are using their time. She’s found that people often spend hours “vegging” out in front of the TV or randomly scrolling through social media. If you have no plan, she said, you choose the path of least resistance, and you end up wasting time doing things that bring you no real enjoyment.

“People have to make a plan,” Netski says. “When you got your job, it didn’t happen by accident. You had a plan. When you go to work, you have a plan on what you’re going to do. Free time is valuable, so you actually do have to plan to do what is enjoyable.”

Netski said there is often a mismatch in what people want in their lives and what they are — or aren’t — doing to achieve it. “They see themselves accomplishing goals, but a lot of the problem is they’re not investing resources to do so. You can’t just hope that things will change. Without some kind of purposeful action, we feel really stuck. Carving out time to accomplish personal goals results in a better outlook on life.” Some of the positive results can be feeling more connected to others, losing the feeling of being powerless, and feeling happier. 

Improve quality of sleep

“As a society, we are very good at depriving ourselves of sleep,” Netski said. “People will tell me they’re tired, that they’re not sleeping well. I ask them what time they go to bed and they’ll say 12:30. When I ask what time they have to be up to go to work, they’ll say 5. That really wears on you. Ideally, sleep time should be closer to eight hours per night for the average person. Without proper sleep, people have problems with concentration, low energy, and there’s a big increase in anxiety.”

It’s too common, Netski said, for people to be plugged into technology at night. Whether they’re connected to TV, email, the web, or video games, there is cognitive stimulation. As the brain revs up, its electrical activity increases and neurons start to race — just the opposite of what should be happening before sleep. Even answering an email can be problematic. It frequently can cause stress and the release of cortisol, a stress hormone that is hardly conducive to a night of good shuteye.

Also, the glow from electronics is not conducive for quality sleep. The blue light from the devices delays or prevents the release of the sleep-inducing hormone melatonin.

“Improved sleep starts with a nighttime routine,” the doctor said. “Set a bedtime that gives you the opportunity to sleep about eight hours, limit screen time before bed, turn off the TV, limit afternoon and evening caffeine.”

Exercise

“There is no escaping exercise when you think about any type of health improvement,” Netski said.

“Small amounts of exercise can have a beneficial impact on your mental health. Studies have shown that as little as one hour per week of brisk exercise, even broken into smaller time increments, will decrease recurrent depression. Exercise also improves sleep quality, decreases anxiety, and increases natural endorphins that improves mood. People who exercise even 10-15 minutes per day will also report improved self-image and pride for doing something for their health.”

Meditate

“This can seem like an overwhelming idea for people who are unfamiliar with the practice of meditation,” she said. Many smartphone apps, as well as audio and traditional books, are available to provide guides for meditation.

Netski pointed out that meditation allows a person to focus on something peaceful and relaxing.

“Even a short meditation can reduce blood pressure, heart rate, and stress hormones, resulting in less anxiety,” she said.

Studies have shown the practice enhances the flow of constructive thoughts and positive emotions, helping individuals live happier lives. Researchers also have found that the part of the brain regulating stress and anxiety actually shrinks when meditation is practiced consistently and that meditation triggers the relaxation response.

“Meditation can be as brief as a 60-second slow deep breathing to a 15-minute or more guided visualization experience,” Netski said. “This is helpful before work or school if you are anticipating a stressful or chaotic day.”

Meditating during a break in the work or school day can help a person refocus. Done in the evening, it can “reduce ruminating about the negative parts of your day,” she said.

Reach out for help

Depression, Netski said, is not just about feeling blue or sad occasionally.

“Everybody has a sad day,” she said. “Depression is a state that lasts at least a couple of weeks. A person can’t enjoy things. There’s no positive emotion for the majority of the day. There’s a negative quality to an individual’s thoughts and he or she feels burdensome to other people. They feel their situation is hopeless. Energy decreases. Sleep is disrupted. And it is very common for suicidal thoughts to accompany this situation.”

Should you find yourself in that situation, Netski said it is critical to reach out to mental health professionals for help.

“It seems to be part of human nature that at times we feel like we are carrying the burden of mankind on our shoulders,” she said. “I often see people that feel shame or stress about talking about stress or their feelings and later report having tremendous relief when they do.”

What definitely is a mistake, Netski emphasized, is for individuals to self-medicate. “It is not uncommon for people to use drugs or alcohol to numb sad, anxious, or depressed feelings, which leads to a worsening condition.”

People need to acknowledge, she said, that sometimes there is a need for help with our mental health, just as there is with a physical condition. Today, she said, there is less stigma about asking for mental health help. “There is much less stigma,” she said. “People have to reach out for help. You can’t assume other people know what’s going on.”

People from all walks of life seek help from mental health professionals, Netski said, adding that a person needing help must ask for it. It’s unrealistic to assume that other people will know what someone needs

Reasons people may need help range from grief and relationship conflict to severe depression, losing touch with reality, or having suicidal thoughts.

“There is always more help for people who feel hopeless,” Netski said. “This year on World Suicide Prevention Day, I received a T-shirt from a colleague that says, 'Tomorrow Needs You,'” and this statement could not ring truer. There is always someone there to listen."

The number is 1-800-273-8255.