Outdoor Recreation Boosts Mental Health

                    <!-- wp:paragraph -->
<p>I love this time of year, and maybe that has a lot to do with where I am blessed enough to live. In the heart of the Allegheny National Forest, I am lucky enough to have wonderful outdoor surroundings. I love when temperatures are finally warm enough to allow for some outdoor walks. Whether it is the trees flowering in my own neighborhood, or the gorgeous wooded hiking trails all around our town, getting outside just seems like a much-needed breath of fresh air!</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>It turns out, I’m not alone in that feeling. Being outdoors can really boost your mental health. And, if you’ve ever taken a look at the lengthy drug warnings that come alongside your antidepressant drugs, you’ve probably noticed that there are plenty of risks in taking them. As someone that has been on them myself for years, I know that the side effects are always a concern for me.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Since my role with MedShadow has broadened my knowledge of medications’ risks and benefits, I am more aware than ever of the <a href="https://medshadow.org/mental-health-matters-what-to-know-about-mental-illness/#Side_Effects_of_Antidepressants_for_Depression_PTSD_Anxiety_OCD_Bipolar_Disorder_Eating_Disorders_and_More" target="_blank" rel="noreferrer noopener">impacts these medications have</a> on my body both short- and long-term. For example, I am grateful I’ve never experienced a side effect as extreme as the possible suicidal ideation attributed to some antidepressants, but I do struggle with side effects like weight gain and raises in blood pressure, which concern me.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Thankfully, there are plenty of ways to mitigate those risks by using natural, non-medication-based solutions. Instead of reaching for another prescription, perhaps try the age-old, sage advice to “stop and smell the roses.” Your productivity and your mood are likely to improve. </p>
<!-- /wp:paragraph -->

<!-- wp:heading -->
<h2 class="wp-block-heading">An Ongoing Struggle with Mental Health</h2>
<!-- /wp:heading -->

<!-- wp:paragraph -->
<p>If you follow <a href="https://medshadow.org/author/mfinley/" target="_blank" rel="noreferrer noopener">my personal blogs and articles with MedShadow</a>, you probably know that I love finding new ways to handle my own conditions with nonmedical remedies. The best way, in my opinion, to avoid the side effects of medication is to use less of them.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>One of my favorite strategies is simply <a href="https://medshadow.org/benefits-of-walking-improve-mental-health/" target="_blank" rel="noreferrer noopener">walking for my mental health</a>. However, for full disclosure, I still struggle with anxiety and depression. These conditions still have me on medication to handle my ever-fluctuating mental health status. But, I do find vast improvements, and have been able to reduce the prescription dosage, as I’ve introduced more natural ways to handle these diseases. I have found, decreasing from 200mg to 100mg of Zoloft each day has made me less drowsy. Both the walking and the lowered dose may be responsible for my (worked-for and intentional) weight loss, too!</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>As spring starts to blossom this year, I am reminded that the <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/seasonal-affective-disorder#:~:text=Seasonal%20affective%20disorder%2C%20or%20SAD,antidepressants%20can%20help%20treat%20SAD." target="_blank" rel="noreferrer noopener">Seasonal Affective Disorder</a> (SAD) tends to worsen my condition. This is the time of the year, thankfully, that I begin to improve. SAD is a seasonal disorder that occurs when the lack of sunlight triggers a chemical response in the brain to induce depression. As I remember that the “outdoors” is a space I can enjoy come spring, my mood tends to improve. I am more active. I have more energy.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>It turns out, I am not the only one who benefits from a nature-supplemented mood. </p>
<!-- /wp:paragraph -->

<!-- wp:heading -->
<h2 class="wp-block-heading">The Great Outdoors Can Improve Your Health</h2>
<!-- /wp:heading -->

<!-- wp:paragraph -->
<p>According to a recent study by the <a href="https://nrpa.org/" target="_blank" rel="noreferrer noopener">National Recreation and Park Association</a> (NRPA)’s  “<a href="https://link.mediaoutreach.meltwater.com/ls/click?upn=qOxUk9boNbzwf-2FyW0pdHlZT0R7UdDslTcJv-2FhoH7p-2FMsoP6HkzHVP0DqmJ4FEWLFmZCVQ7AN-2BA8IxXT0dXDWJLYWaPrg0v51DmEmaagNuTwsAP22KMHzZrbiOhFCo86JV7lr_YR38rdyOJyMob9JceCbx7e2GkZ2aIWlFxIJKElt1SLAILQzRbDYCo-2Fc8AsVgKBlVSqf26M0AysT9kr2zdqUxnfbUMiXMM8xZzneIljIlYYmCSUr96e0DaVlPL-2B4KoWsqwUPqpBxHz40CUCFecO9QQnYDen-2FOZsg8xBxxUNmtDqan1f6RtYGOu-2B9JAawgzOG-2B23Z-2BoryW7aRMym03a7-2BQGR8MlOreWrOsLr44yJYTMxdyTIX-2BLtj2fgiOxiF2v-2FVP3CMmv4mz1hJXC7ker78VClWFWo3ZcJ1DxFhpJEoUJZc5l6cxT57EE8LKnqXJ-2Fqr5zY3Oicb5NwvxOUpE2aXl919Q88Xy-2BHiPkWaawXMhyscU98YOpUgDlDJgSe2GxvD9" target="_blank" rel="noreferrer noopener">Park Pulse” poll</a>, 92%  of U.S adults experience a positive mental health boost after spending time at their local parks. NRPA  is a not-for-profit organization with a mission of “building strong, vibrant and resilient communities through the power of parks and recreation.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Visiting parks and participating in recreational activities can improve mood and boost energy. Not only do parks and recreation provide opportunities for physical health, but also they provide mental health benefits.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>There is plenty of evidence to show that time spent in nature positively impacts mental health. Signs like increased cognitive performance, an overall better sense of well-being,  and an ability to  alleviate illnesses, such as depression, attention deficit disorders (such as ADHD), and Alzheimer’s, have all come from time outside.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p> According to the NRPA study:</p>
<!-- /wp:paragraph -->

<!-- wp:list -->
<ul class="wp-block-list"><!-- wp:list-item -->
<li>Ninety-two percent of U.S. adults experience a positive mental health boost after spending time at their local parks.</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Women are more likely than men to say they feel calm or peaceful after visiting their local parks (62% vs. 55%).</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Millennials are more likely than baby boomers to feel happy or joyful after spending time at their local park (53% vs. 40%).</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Those from households of three or more are more likely to feel happy or joyful after spending time at their local park (52%) compared to those who live with one other person (42%) or by themselves (34%). Larger households also feel more energized after their visit (32% vs. 20% vs. 21%).</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Nearly three in five parents (57%) feel happy or joyful after spending time at their local park, compared to 40% of non-parents.</li>
<!-- /wp:list-item --></ul>
<!-- /wp:list -->

<!-- wp:paragraph -->
<p>“The positive impact of parks leaves many individuals healthier, happier, and less reliant on local medical and mental health services,” says Melissa May, NRPA senior manager of research. “Access to quality parks and recreation can help improve health outcomes for every community.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887757/" target="_blank" rel="noreferrer noopener">One United Kingdom-based study</a> showed that participants who answered a questionnaire before and after enjoying a wetland open space had “greater mental wellbeing and positive affect, and less anxiety, negative affect and perceived stress after their time in nature. Clinically meaningful differences were observed in WEMWBS scores, with the group mean no longer corresponding to a ‘probable depression’ diagnosis.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>“Participants consistently described a positive relationship between engaging in the wetland [park exposure]  and improved mental health,” said the study. “Several participants emphasized how they felt less anxious during the sessions [time outdoors].”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>A <a href="https://www.who.int/" target="_blank" rel="noreferrer noopener">World Health Organization</a>-sponsored <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6873641/" target="_blank" rel="noreferrer noopener">review in 2019</a> even noted that studies have shown a correlation between green spaces and mortality rates.</p>
<!-- /wp:paragraph -->

<!-- wp:heading {"level":3} -->
<h3 class="wp-block-heading">Green Space to Combat Alzheimer’s Disease </h3>
<!-- /wp:heading -->

<!-- wp:paragraph -->
<p><a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799727" target="_blank" rel="noreferrer noopener">One December 2022  study</a> reviewed 62 million Medicare patients throughout the U.S. and found that those “living areas with  more green space had a lower rate of hospitalization related to Alzheimer’s disease, Parkinson’s, and related dementias.” The more the green, open space found in an area, the less hospitalizations of residents due to dementia were found. People with dementia are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955171/" target="_blank" rel="noreferrer noopener">most often hospitalized</a> due to falls, heart disease, digestive issues, pneumonia or delirium.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Parks themselves may not be the sole reason for the correlation, but the study’s author, Jochem Klompmaker, a postdoctoral research fellow at the <a href="https://www.hsph.harvard.edu/" target="_blank" rel="noreferrer noopener">Harvard T.H. Chan School of Public Health</a>, told the <a href="https://www.sierraclub.org/sierra/can-outdoor-access-reduce-risk-dementia#:~:text=The%20study%20of%20nearly%2062,body%20dementia%20and%20vascular%20dementia)." target="_blank" rel="noreferrer noopener">Sierra Club</a> that the results might be “linked to healthier lifestyle choices encouraged by easier access to the outdoors.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>“Dementia is affected by age and genetics,” Klompmaker said in a June 2023 interview with the Sierra Club. “You can’t modify those factors, unfortunately. . . . [But] there’s increasing evidence that a healthy lifestyle can slow your risk—and living near green space can encourage a healthier lifestyle.” </p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>The Sierra Club also spoke to Don Elbert, an associate professor of neurology at the <a href="https://www.washington.edu/" target="_blank" rel="noreferrer noopener">University of Washington</a>, who was not involved in the research, but said that the correlation may be because “living near green spaces might lead to higher levels of physical activity and also be correlated with fewer pollutants.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>“The combination of those two things is definitely helpful,” Elbert said to the Sierra Club. Elbert, however, noted that “ lifestyle changes could only slow, not stop, disease progressions.“</p>
<!-- /wp:paragraph -->

<!-- wp:heading {"level":3} -->
<h3 class="wp-block-heading">Outdoor Surroundings Improve ADHD Symptoms</h3>
<!-- /wp:heading -->

<!-- wp:paragraph -->
<p>It is not just dementia-related conditions that improve when people step outside. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448497/" target="_blank" rel="noreferrer noopener">One 2004 study</a> found that students with ADHD had reduced symptoms of the condition when studying outside. The study largely honed in on the ability to focus as a primary symptom. The study noted that the kids were better able to focus after participating in activities  in green outdoor settings than after doing the same activities in other settings.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>The “green doses” in the study included a variety of options, such as “choosing a greener route for the walk to school, doing classwork or homework at a window with a relatively green view, or playing in a green yard or ball field at recess and after school.” </p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>The study also suggested that the use of “green doses” (or times outdoors) might help lower or eliminate a need for medication.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>“While medications are effective for most children with ADHD, they are ineffective for some, and other children cannot tolerate them,” said the study, which was published in the <a href="https://ajph.aphapublications.org/" target="_blank" rel="noreferrer noopener">American Journal of Public Health</a>. “In the case of children for whom medication is tolerable and effective, exposure to green settings as part of their daily routine might augment the medication’s effects, offering more complete relief of symptoms and helping children function more effectively both at school and at home.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>The study noted that a “green dose” (or several of them) might help children reduce medications by an entire dose per day. It said that those children who do not tolerate medication may also feel benefits with a “regular regime of green views” or time outdoors.</p>
<!-- /wp:paragraph -->

<!-- wp:heading {"level":3} -->
<h3 class="wp-block-heading">Wilderness for Better Health</h3>
<!-- /wp:heading -->

<!-- wp:paragraph -->
<p>There are a number of research studies that show depression symptoms can be improved with exposure to the great outdoors.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://pubmed.ncbi.nlm.nih.gov/32571202/" target="_blank" rel="noreferrer noopener">One 2020 study noted</a> that “<a href="https://medshadow.org/forest-bathing-relax/" target="_blank" rel="noreferrer noopener">forest bathing</a>,” or the act of simply spending time in nature, reduced hypertension and prehypertension in patients. It also was said to reduce heart rate and improve biomarkers for immune health.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://www.mind.org.uk/about-us/what-we-do/" target="_blank" rel="noreferrer noopener">Mind.org</a>, a nonprofit organization based in the United Kingdom, says that “<a href="https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/ecotherapy/" target="_blank" rel="noreferrer noopener">ecotherapy</a>” has been shown to make marked improvements in those with depression. Ecotherapy is a “formal treatment which involves doing activities in nature.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>“Research into ecotherapy has shown it can help with mild to moderate depression,” says the website. “This might be due to combining regular physical activity and social contact with being outside in nature.”</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>It also notes benefits of ecotherapy when it comes to SAD.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>“Being outside in natural light can be helpful if you experience SAD, a type of depression that affects people during particular seasons or times of year,” says the site. “And people tell us that getting into nature has helped them with many <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/" target="_blank" rel="noreferrer noopener">other types of mental health problems</a>.”</p>
<!-- /wp:paragraph -->

<!-- wp:heading -->
<h2 class="wp-block-heading">Side Effects of Antidepressants</h2>
<!-- /wp:heading -->

<!-- wp:paragraph -->
<p>If you are still on the fence that nature can be a benefit to your mental health or various mental conditions, it isn’t hard to compare the pros and cons. When it comes to the Great Outdoors, your worst-case scenarios may include “side effects” like being caught in a rainstorm, suffering from <a href="https://medshadow.org/spring-is-here-and-so-are-your-allergies/" target="_blank" rel="noreferrer noopener">seasonal allergies</a>, mosquitos or ants “<a href="https://medshadow.org/bug-spray-safe/" target="_blank" rel="noreferrer noopener">bugging</a>” you during your enjoyable activities, or <a href="https://medshadow.org/safe-sunscreen-2021/" target="_blank" rel="noreferrer noopener">sunburns</a> if you aren’t taking necessary precautions.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>With antidepressant medications, the potential side effects list is a bit longer.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Antidepressants are used to treat a variety of mental health disorders. The most common type of antidepressants are SSRIs (selective serotonin reuptake inhibitors). They work by preventing your brain cells from recycling a neurotransmitter called serotonin, leaving more of it available to act in your brain. Some SSRIs include Zoloft (sertraline), citalopram, Prozac, or Priligy.  </p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Scientists have long suggested that people with depression often have lower levels of serotonin, which is known to be involved in satisfaction and happiness, and that making more of the neurotransmitter available should treat depression. That idea is <a href="https://www.nature.com/articles/s41380-022-01661-0" target="_blank" rel="noreferrer noopener">currently being debated</a> in the scientific community. It is not entirely clear if everyone that is depressed, for example, has a lower level of serotonin. </p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Other types of antidepressants, including SNRIs (serotonin norepinephrine reuptake inhibitors,) such as Cymbalta (duloxetine) MAOIs (monoamine oxidase inhibitors), Nardil (phenelzine,) and <a href="https://www.ncbi.nlm.nih.gov/books/NBK557791/#:~:text=They%20block%20the%20reuptake%20of,to%20its%20anti%2Ddepressive%20effect." target="_blank" rel="noreferrer noopener">tricyclic antidepressants</a>, (amitriptyline), all similarly increase the availability of serotonin in your brain. </p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>Some side effects of SNRI antidepressants include:</p>
<!-- /wp:paragraph -->

<!-- wp:list -->
<ul class="wp-block-list"><!-- wp:list-item -->
<li>Increased risk of emergency room visits or death for seniors who also have COPD (15% and 20%, respectively)</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Weight gain</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Excessive <a href="https://medshadow.org/antidepressants-problematic-side-effects/" target="_blank" rel="noreferrer noopener">sweating</a></li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li><a href="https://www.uptodate.com/contents/image?imageKey=PC%2F81374" target="_blank" rel="noreferrer noopener">Nausea</a></li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Drowsiness</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Jitteriness </li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Rise in blood pressure (venlafaxine, specifically)</li>
<!-- /wp:list-item -->

<!-- wp:list-item -->
<li>Suicidal thoughts </li>
<!-- /wp:list-item --></ul>
<!-- /wp:list -->

<!-- wp:paragraph -->
<p>To read more about the risk of suicidal thoughts and actions, read MedShadow’s <a href="https://medshadow.org/ssris-and-suicide-risk-in-those-with-depression/" target="_blank" rel="noreferrer noopener">SSRIs and Suicide Risk in Those With Depression</a>.</p>
<!-- /wp:paragraph -->

<!-- wp:heading -->
<h2 class="wp-block-heading">The Choice Is Yours</h2>
<!-- /wp:heading -->

<!-- wp:paragraph -->
<p>I’m not a doctor , but I  can share my personal experiences. Living in the <a href="https://www.fs.usda.gov/allegheny/" target="_blank" rel="noreferrer noopener">Allegheny National Forest</a>, I am blessed with  the amazing outdoors year-round.  I can feel the impact when I hibernate indoors during winter cold or spring’s heavy rains. I lack energy. I am tired far earlier in the day. I long to stay in pajamas, no matter the time on the clock. </p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>However, being outside in the fresh air isn’t exclusive to those of us living in a national forest. A simple walk around the block through your neighborhood, a stop at the city’s park, or a jaunt to the playground with the kids can all get you out of the house, and into nature.</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>It’s a beautiful day today. I’m going to file this blog and get outside to take a walk. </p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p>For more reading on the benefits of outdoor experiences and your health, read additional MedShadow articles here:</p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://medshadow.org/outdoor-workouts-when-you-dont-feel-like-running/" target="_blank" rel="noreferrer noopener">Outdoor Workout, When You Don’t Feel Like Running</a></p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://medshadow.org/benefits-of-walking-improve-mental-health/" target="_blank" rel="noreferrer noopener">Benefits of Walking: How to Improve Your Mental Health</a></p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://medshadow.org/a-little-less-medicine-a-little-more-camping/" target="_blank" rel="noreferrer noopener">A Little Less Medicine, A Little More Camping</a></p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://medshadow.org/social-prescribing/" target="_blank" rel="noreferrer noopener">What if Your Doctor Could Prescribe Fishing Trips or Art Classes? Social Prescribing on The Rise</a></p>
<!-- /wp:paragraph -->

<!-- wp:paragraph -->
<p><a href="https://medshadow.org/forest-bathing-relax/" target="_blank" rel="noreferrer noopener">Can Forest Bathing Keep You Healthy?</a></p>
<!-- /wp:paragraph -->