It’s no secret that the American healthcare system is in dire need of repair. It’s tough to get the care you need, even if you do have health insurance, because it’s so expensive. And for mental healthcare, it’s even harder because many therapists don’t accept insurance or aren’t taking new patients.
Fortunately, there are a host of things that you can do to care for your mental health even if you don’t have access to therapy. I spoke to some experts, and here’s what they say are surefire ways to stay sane in an often-insane world.
Attend 12 step meetings
No matter where you are, be it urban, suburban, or rural, in every city and town in the United States, there is a 12 step meeting within a reasonable distance from your home. And if you reach out, there’s someone who will make sure you get there safely, and back home too.
Christopher Gerhart, a licensed and certified substance abuse counselor, told me, “Alcoholics Anonymous (AA), Cocaine Anonymous (CA), and Narcotics Anonymous offer some of the best therapy you can buy for $1.00 per hour. Yes, these groups may not be the best fit for every person; however, they are a place where people are seeking a solution.” So even if you aren’t struggling with addiction, you are still welcome, and you will be given support.
Gerhart continued, “A quick caveat: show up early and stay late so that you can meet the people who are actively involved. Just like work, school, or church, those that are enthusiastic about their participation spend some time there.” So as long as there are 12 step groups, you’ll never be alone.
The term “self-care” is a buzzword that is tossed around liberally in casual conversation. For some, it can mean taking the day off of work to binge a Netflix series, or spending a day shopping or otherwise splurging.
But for folks with mental health issues, self-care is an imperative that we often neglect, which has consequences. So if you want to stay above water, don’t let self-care fall by the wayside, even when it seems like a chore.
Courtney Rodrigue, a licensed mental health counselor, told me, “Good self-care is essential for overall well-being. This includes mental health: take time (schedule it if necessary) for yourself and engage in activities that are not only good for you, but also things you enjoy. This can include cooking a beautiful meal, going to a yoga class, or taking a bubble bath on a weeknight.” And all of these things cost less than regular therapy sessions.
Cultivate a morning routine
The morning can be an especially tough time of day when you’re struggling with depression or anxiety. It’s easy to wake up and feel negative about everything, and fall into an even deeper rut. That’s why it’s critical to have a morning routine that shakes you out of your funk, even if it’s just a little bit. And the experts agree.
Kimberly Hershenson, a NYC-based therapist, emphasized this importance. “Have a morning routine where you have time to yourself, whether it’s going to the gym, having your daily coffee while reading the newspaper, or stretching for ten minutes,” she said. “Doing something just for yourself every day is crucial to mental health.” So no matter how small the activity may be, it’s still good for you.
Another way to direct your morning is with positive affirmations that open your mind to good outcomes. Hershenson recommends, “Read affirmations every morning. Starting your day with positivity kick starts your day on the right foot.” So therapy or no, you’re putting in the work.
I recently had a health issue (unrelated to my mental health) that landed me in the hospital overnight. By the time they let me go the next evening, I was so ready to go. And I was thrilled to get back to my home, my things, and my family. I was intensely grateful.
Now that didn’t make everything in the world suddenly perfect, but it gave me some fresh and important perspective. So how can you cultivate sincere gratitude on a daily basis, minus hospital visits? Like therapy, you work at it.
Linda Stiles, a certified Imago therapist, told me, “Our brain is wired to focus on the negative. We can help counter this by intentionally focusing on the positive things in our life. Studies show that a gratitude practice, such as making a list of three things we appreciate each day, can improve our mood and outlook. We can teach ourselves to notice and appreciate positive things even when we have challenging circumstances.” So every day, really try to focus on the things you do have. It helps. And plenty of therapists would agree.
Unplug each night
One of the most important ways to care for your mental health is to get enough sleep. But that’s easier said than done. According to the CDC, one in three Americans don’t get enough sleep, which is a pretty staggering statistic. And if you’re one of those Americans, you’re more susceptible to developing a mental illness, such as depression. And if you have a mental illness like anxiety, it’s already difficult enough to have a healthy sleep pattern.
One proven way that you can get a better night’s rest is by ditching your screens. Hershenson told me that it’s beneficial to your mental health if you take a technology break. “Turn off the TV, computer, and your phone an hour before bed,” she said. “Technology stimulates the brain, causing our minds to stay active and unable to wind down. Turning off technology allows us to slow down and prepares the body for rest.”
And if you have trouble doing this, keep a book or magazine on your nightstand — that will be stimulating without keeping you awake.
Build a support network
It really is beneficial to have a squad, because caring for your mental health in isolation is exceedingly difficult. Even the most introverted people need support from others, so make sure you’re nurturing your support network.
Tyra Butler, a marriage and family therapist, recommended “talking with supportive people, either through friends or family, or support groups found at churches, community groups, or other social or hobby groups. Finding supportive people to talk to increases feelings of being cared about and belonging with other people.” And if you feel cared for, then you’ll feel a lot less alone.
Butler also noted that, “People also can offer good advice or simply be with a person during a difficult time, which has the benefit of feeling connected and important to others.” So even if you’re just showing up and hanging out, you’ll reap the therapeutic benefits of human contact.
Sweat it out
I’ve been working out regularly since 2002 — about fifteen years. And I am by no means “in shape,” or thin by any measure. But my reasoning for getting on the elliptical for an hour a day has little to do with physical fitness; rather, it keeps me sane. So I keep doing it. And I’m not the only person who notices that it helps.
Teresa Solomita, a licensed psychoanalyst and therapist, told me that moving your body is key. “Whether it’s yoga, running, or pick up basketball, exercise is a natural anti-depressant,” she said. “Exercise releases endorphins that interact with the receptors in your brain, reducing your perception of pain and triggering a positive feeling in your body.” So it’s no surprise that fierce cardio helps me keep sane. Plus it’s cheap and/or free to get your sweat on.
Alisa Kamis-Brinda, a licensed psychotherapist in Philadelphia, agreed, telling me that, “The better you feel physically, the better you will feel emotionally. Additionally, for people with anxiety, exercise lowers the stress hormones adrenaline and cortisol which are elevated when someone is feeling anxious, stressed, or overwhelmed.” So it’s a no-brainer. If you work your body, you will help your mind.
Any dietitian will tell you about the importance of eating a balanced diet; we need essential nutrients in our diet in order to function in our daily lives. But it’s also important for mental health.
Kamis-Brinda told me, “Eating healthy is also important for good self-care. As with exercise, the better you feel physically, the better you will feel emotionally. Foods high in protein and fiber help to keep sugar levels in the body stable, also helping to stabilize anxiety. Complex carbohydrates promote serotonin in the brain, which helps to regulate mood, sleep, and appetite.”
Additionally, if you’re prone to anxiety, avoiding certain foods can help. Kamis-Brinda continued, “Avoiding caffeine and sugar helps with anxiety, as these ingredients mimic the biological processes of anxiety, making people feel anxious even when they are not.” So take stock of how you feel after eating certain foods, especially coffee — you might be surprised at how it can affect you.
Utilize online resources
There is an incredible amount of material online that you can access to help you maintain your mental health. And while it’s no replacement for therapy, it’s certainly a serious help when you’re in need of counsel. Erika Martinez, a licensed psychologist, told me about the myriad of options.
“Read therapist blogs. Many therapists blog about topics that they know are meaningful to the clients they serve. Find a few therapists who specialize in the issue you’re facing and keep up with their posts,” she said. “PsychCentral and Psychology Today have some great ones from practicing clinicians on an array of issues.” You can also subscribe to their online newsletters and mailings, and follow their social media accounts for practical advice.
And that’s not all. Martinez continued, “Listen to podcasts/YouTube channels by mental health providers. There are some great mental health podcasts out there produced by practicing clinicians. Subscribe and listen. Often they invite other therapists who blog to speak about certain topics. This way you can read and listen to your favorite mental health providers.”
Finally, there are online sites like 7 Cups, which provide free, confidential calls from trained listeners.
Meditation can be a great tool if you’re lacking focus in your life, or want to connect with your body more. Plus, it really does help you calm down.
Solomita told me, “Meditation is known to calm the nervous system, reduce the negative response to stress, and foster acceptance. The beauty of meditation is that it can be done anywhere, anytime, for free and for as little as ten minutes per day. A regular practice will reap regular rewards.”
So even if you’re broke, you can always take a few minutes to sit down and just be, giving that time to yourself. There are also tons of meditation apps out there, some of them free, to guide you in your practice. If you find you really enjoy the practice, you can also check out meditative yoga classes in your community.
Scout for free clinics
It’s a myth that you can only get therapy for an expensive hourly rate. Many therapists will offer a sliding scale for payment, and if you happen to be in a big city or near a university, you might even have access to low-cost — if not free — care.
I spoke to Dr. Crystal I. Lee, a licensed psychologist in Los Angeles, and owner of LA Concierge Psychologist, and she told me, “If you live near a school with a doctoral psychology program, chances are that they have a free or low-cost psychology clinic. You’ll be working with doctoral trainees, but they are closely supervised by veteran psychologists.”
And there is a perk to this method as well. Lee continued, “These trainees see fewer clients per week, so they’re able to devote more time thinking about their cases and discussing it with their supervisor, which is a great benefit!” So get in touch with your local school and see what they have to offer.
Have a holistic approach
There’s no magic bullet that can make everything in our lives perfect. But certainly if you take a multi-pronged approach to caring about your mental health, you will find yourself improving, even if it’s only in small ways. By putting in the work and not giving into laziness or mind-numbing coping mechanisms, you give yourself the gift of things getting better. And most of the time? They can, will, and do.