Gratitude in the Workplace Improves Employee Health

It turns out that making people feel valued goes a long way.

If you knew that expressing gratitude to a colleague would improve their life and yours, would you do it more often?

A new study by Portland State University researchers — business professor David Cadiz, psychology professor Cynthia Mohr, and Alicia Starkey, a recent Ph.D. graduate in psychology — together with Clemson State University professor Robert Sinclair, exhibits a positive relationship between expressed workplace gratitude, physical health and mental health.

The study, “Gratitude reception and physical health: Examining the mediating role of satisfaction with patient care in a sample of acute care nurses,” shows that being thanked more often at work predicted better sleep, fewer headaches and healthier eating, because it improved nurses’ work satisfaction.

Improving Self-Care in a Stressful Work Environment

The study involved a group of Oregon nurses, a profession that has a particularly high rate of burnout. Cadiz discusses the findings and how applying the research can have a significant impact on quality of life and job retention by preventing stress-related illnesses and disease.

“Nurses tend to have a thankless job. It’s very physical, and they’re often being screamed at by patients who are at their lowest. When nurses receive gratitude, it boosts them,” Cadiz explains.

“This type of study helps us understand how to keep nurses in the workforce in a healthy way. Nurses strongly align their profession with their identity and often look out for patients more than themselves. The gratitude matches up with their identity, gives them satisfaction in a job well done and ultimately increases self-care.”

Many people inherently connect their identity to their job and feelings of appreciation within their roles. Employers who understand and react to this can create positive social and economic change.

Gratitude is Good Business

From an organizational, policy and leadership perspective, Cadiz says that employers should create formal or informal opportunities for people to express gratitude. Including gratitude in a business plan is an essential step that many business leaders miss, and that omission can have financial consequences.

“Employees that receive positive feedback are healthier, and that can impact the bottom line,” adds Cadiz. “Preventing headaches and other stress-related symptoms means fewer sick days, and, in this case, cuts down the cost of replacement nurses and overtime pay.”

These small changes can have a dramatic fiscal impact over time, which can result in more staff, better pay rates and increased benefits.

The big takeaway — express gratitude when you see someone doing a good job. A positive feedback loop impacts you and those around you, and can ultimately shape a healthier and happier community.

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Just 20 Minutes in Nature Reduces Stress Levels

A good prescription for a stressed out society.

Taking at least twenty minutes out of your day to stroll or sit in a place that makes you feel in contact with nature will significantly lower your stress hormone levels. That’s the finding of a study that has established for the first time the most effective dose of an urban nature experience. Healthcare practitioners can use this discovery, published in Frontiers in Psychology, to prescribe ‘nature-pills’ in the knowledge that they have a real measurable effect.

“We know that spending time in nature reduces stress, but until now it was unclear how much is enough, how often to do it, or even what kind of nature experience will benefit us,” says Dr. MaryCarol Hunter, an Associate Professor at the University of Michigan and lead author of this research. “Our study shows that for the greatest payoff, in terms of efficiently lowering levels of the stress hormone cortisol, you should spend 20 to 30 minutes sitting or walking in a place that provides you with a sense of nature.”

A free and natural stress-relieving remedy

Nature pills could be a low-cost solution to reduce the negative health impacts stemming from growing urbanization and indoor lifestyles dominated by screen viewing. To assist healthcare practitioners looking for evidence-based guidelines on what exactly to dispense, Hunter and her colleagues designed an experiment that would give a realistic estimate of an effective dose.

Over an 8-week period, participants were asked to take a nature pill with a duration of 10 minutes or more, at least 3 times a week. Levels of cortisol, a stress hormone, were measured from saliva samples taken before and after a nature pill, once every two weeks.

“Participants were free to choose the time of day, duration, and the place of their nature experience, which was defined as anywhere outside that in the opinion of the participant, made them feel like they’ve interacted with nature. There were a few constraints to minimize factors known to influence stress: take the nature pill in daylight, no aerobic exercise, and avoid the use of social media, internet, phone calls, conversations and reading,” Hunter explains.

She continues, “Building personal flexibility into the experiment, allowed us to identify the optimal duration of a nature pill, no matter when or where it is taken, and under the normal circumstances of modern life, with its unpredictability and hectic scheduling.”

To make allowances for busy lifestyles, while also providing meaningful results, the experimental design was novel in other aspects too.

“We accommodated day to day differences in a participant’s stress status by collecting four snapshots of cortisol change due to a nature pill,” says Hunter. “It also allowed us to identify and account for the impact of the ongoing, natural drop in cortisol level as the day goes on, making the estimate of effective duration more reliable.”

Nature will nurture

The data revealed that just a twenty-minute nature experience was enough to significantly reduce cortisol levels. But if you spent a little more time immersed in a nature experience, 20 to 30 minutes sitting or walking, cortisol levels dropped at their greatest rate. After that, additional de-stressing benefits continue to add up but at a slower rate.

“Healthcare practitioners can use our results as an evidence-based rule of thumb on what to put in a nature-pill prescription,” says Hunter. “It provides the first estimates of how nature experiences impact stress levels in the context of normal daily life. It breaks new ground by addressing some of the complexities of measuring an effective nature dose.”

Hunter hopes this study will form the basis of further research in this area.

“Our experimental approach can be used as a tool to assess how age, gender, seasonality, physical ability and culture influences the effectiveness of nature experiences on well-being. This will allow customized nature pill prescriptions, as well as a deeper insight on how to design cities and wellbeing programs for the public.”

Mental Health Disorders Have Increased Significantly Among Teens and Young Adults

Mental health issues are one of the defining problems of this era.

The percentage of young Americans experiencing certain types of mental health disorders has risen significantly over the past decade, with no corresponding increase in older adults, according to research published by the American Psychological Association.

“More U.S. adolescents and young adults in the late 2010s, versus the mid-2000s, experienced serious psychological distress, major depression or suicidal thoughts, and more attempted suicide,” said lead author Jean Twenge, PhD, author of the book “iGen” and professor of psychology at San Diego State University. “These trends are weak or non-existent among adults 26 years and over, suggesting a generational shift in mood disorders instead of an overall increase across all ages.”

The research was published in the Journal of Abnormal Psychology.

Twenge and her co-authors analyzed data from the National Survey on Drug Use and Health, a nationally representative survey that has tracked drug and alcohol use, mental health and other health-related issues in individuals age 12 and over in the United States since 1971. They looked at survey responses from more than 200,000 adolescents age 12 to 17 from 2005 to 2017, and almost 400,000 adults age 18 and over from 2008 to 2017.

The rate of individuals reporting symptoms consistent with major depression in the last 12 months increased 52 percent in adolescents from 2005 to 2017 (from 8.7 percent to 13.2 percent) and 63 percent in young adults age 18 to 25 from 2009 to 2017 (from 8.1 percent to 13.2 percent). There was also a 71 percent increase in young adults experiencing serious psychological distress in the previous 30 days from 2008 to 2017 (from 7.7 percent to 13.1 percent). The rate of young adults with suicidal thoughts or other suicide-related outcomes increased 47 percent from 2008 to 2017 (from 7.0 percent to 10.3 percent).

There was no significant increase in the percentage of older adults experiencing depression or psychological distress during corresponding time periods. The researchers even saw a slight decline in psychological distress in individuals over 65.

“Cultural trends in the last 10 years may have had a larger effect on mood disorders and suicide-related outcomes among younger generations compared with older generations,” said Twenge, who believes this trend may be partially due to increased use of electronic communication and digital media, which may have changed modes of social interaction enough to affect mood disorders. She also noted research shows that young people are not sleeping as much as they did in previous generations.

The increase in digital media use may have had a bigger impact on teens and young adults because older adults’ social lives are more stable and might have changed less than teens’ social lives have in the last ten years, said Twenge. Older adults might also be less likely to use digital media in a way that interferes with sleep — for example, they might be better at not staying up late on their phones or using them in the middle of the night.

“These results suggest a need for more research to understand how digital communication versus face-to-face social interaction influences mood disorders and suicide-related outcomes and to develop specialized interventions for younger age groups,” she said.

Given that the increase in mental health issues was sharpest after 2011, Twenge believes it’s unlikely to be due to genetics or economic woes and more likely to be due to sudden cultural changes, such as shifts in how teens and young adults spend their time outside of work and school. If so, that may be good news, she said.

“Young people can’t change their genetics or the economic situation of the country, but they can choose how they spend their leisure time. First and most important is to get enough sleep. Make sure your device use doesn’t interfere with sleep — don’t keep phones or tablets in the bedroom at night, and put devices down within an hour of bedtime,” she said. “Overall, make sure digital media use doesn’t interfere with activities more beneficial to mental health such as face-to-face social interaction, exercise and sleep.”

Link Between Bad Diets and Psychological Distress Found

There’s a reason it’s called junk food.

A study has found that poor mental health is linked with poor diet quality — regardless of personal characteristics such as gender age, education, age, marital status and income level.

The study, published Feb. 16 in the International Journal of Food Sciences and Nutrition, revealed that California adults who consumed more unhealthy food were also more likely to report symptoms of either moderate or severe psychological distress than their peers who consume a healthier diet.

Jim E. Banta, PhD, MPH, associate professor at Loma Linda University School of Public Health and lead author of the study, said the results are similar to previous studies conducted in other countries that have found a link between mental illness and unhealthy diet choices. Increased sugar consumption has been found to be associated with bipolar disorder, for example, and consumption of foods that have been fried or contain high amounts of sugar and processed grains have been linked with depression.

“This and other studies like it could have big implications for treatments in behavorial medicine,” Banta said. “Perhaps the time has come for us to take a closer look at the role of diet in mental health, because it could be that healthy diet choices contribute to mental health. More research is needed before we can answer definitively, but the evidence seems to be pointing in that direction.”

Banta cautioned that the link found between poor diet and mental illness is not a causal relationship. Still, he said the findings from California build upon previous studies and could affect future research and the approaches that healthcare providers administer for behavioral medicine treatments.

In their study, Banta and his team reviewed data from more than 240,000 telephone surveys conducted between 2005 and 2015 as part of the multi-year California Health Interview Survey (CHIS). The CHIS dataset includes extensive information about socio-demographics, health status and health behaviors and was designed to provide statewide approximations for regions within California and for various ethnic groups.

The study found that nearly 17 percent of California adults are likely to suffer from mental illness — 13.2 percent with moderate psychological distress and 3.7 percent with severe psychological distress.

The study stated that the team’s findings provide “additional evidence that public policy and clinical practice should more explicitly aim to improve diet quality among those struggling with mental health.” It also stated that “dietary interventions for people with mental illness should especially target young adults, those with less than 12 years of education, and obese individuals.”

Healthier Diets Reduce Depressive Symptoms

There’s research that has again verified this connection.

An analysis of data from almost 46,000 people has found that weight loss, nutrient boosting and fat reduction diets can all reduce the symptoms of depression.

Dr Joseph Firth, an Honorary Research fellow at The University of Manchester and Research Fellow at NICM Health Research Institute at Western Sydney University, says existing research has been unable to definitively establish if dietary improvement could benefit mental health.

But in a new study published in Psychosomatic Medicine, Dr Firth and colleagues brought together all existing data from clinical trials of diets for mental health conditions.

And the study provides convincing evidence that dietary improvement significantly reduces symptoms of depression, even in people without diagnosed depressive disorders.

Dr Firth said: “The overall evidence for the effects of diet on mood and mental well-being had up to now yet to be assessed.

“But our recent meta-analysis has done just that; showing that adopting a healthier diet can boost peoples’ mood. However, it has no clear effects on anxiety.”

The study combined data from 16 randomised controlled trials that examined the effects of dietary interventions on symptoms of depression and anxiety.

Sixteen eligible trials with outcome data for 45,826 participants were included; the majority of which examined samples with non-clinical depression.

The study found that all types of dietary improvement appeared to have equal effects on mental health, with weight-loss, fat reduction or nutrient-improving diets all having similar benefits for depressive symptoms.

“This is actually good news” said Dr Firth; “The similar effects from any type of dietary improvement suggests that highly-specific or specialised diets are unnecessary for the average individual.

“Instead, just making simple changes is equally beneficial for mental health. In particular, eating more nutrient-dense meals which are high in fibre and vegetables, while cutting back on fast-foods and refined sugars appears to be sufficient for avoiding the potentially negative psychological effects of a ‘junk food’ diet.

Dr Brendon Stubbs, co-author of the study and Clinical Lecturer at the NIHR Maudsley Biomedical Research Centre and King’s College London, added: “Our data add to the growing evidence to support lifestyle interventions as an important approach to tackle low mood and depression.

“Specifically, our results within this study found that when dietary interventions were combined with exercise, a greater improvement in depressive symptoms was experienced by people. Taken together, our data really highlight the central role of eating a healthier diet and taking regular exercise to act as a viable treatment to help people with low mood.”

Studies examined with female samples showed even greater benefits from dietary interventions for symptoms of both depression and anxiety.

Eating More Fruits and Vegetables Can Improve Mental Health

It makes sense that improvements in diet can improve not only physical but mental health as well.

The research showed a positive association between the quantity of fruit and vegetables consumed and people’s self-reported mental well-being.

Specifically, the findings indicate that eating just one extra portion of fruits and vegetables a day could have an equivalent effect on mental well-being as around 8 extra days of walking a month (for at least 10 minutes at a time).

Dr Neel Ocean of the University of Leeds, who authored the study with Dr Peter Howley (University of Leeds) and Dr Jonathan Ensor (University of York), said: “It’s well-established that eating fruit and vegetables can benefit physical health.

“Recently, newer studies have suggested that it may also benefit psychological well-being. Our research builds on previous work in Australia and New Zealand by verifying this relationship using a much bigger UK sample.

“While further work is needed to demonstrate cause and effect, the results are clear: people who do eat more fruit and vegetables report a higher level of mental well-being and life satisfaction than those who eat less.”

Dr Howley said: “There appears to be accumulating evidence for the psychological benefits of fruits and vegetables. Despite this, the data show that the vast majority of people in the UK still consume less than their five-a-day.

Experimental Electric Therapy to Treat Mental Health Problems is Curing PTSD

This is unique research, although it is difficult to determine how valuable it is or its potential for misuse, but its potential of treating mental health disorders — an immense problem in modern society — makes it worth mentioning.

Hundreds of vets have tried out an experimental new treatment that could change how the world addresses mental disorders.

Tony didn’t know what to expect when he walked into the Brain Treatment Center in San Diego, California, last spring. The former Navy SEAL only knew that he needed help. His service in Iraq and Afghanistan was taking a heavy toll on his mental and physical wellbeing. He had trouble concentrating, remembering, and was given to explosive bursts of anger. “If somebody cut me off driving, I was ready to kill ’em at the drop of a hat,” he said. And after he got into a fistfight on the side of a California road, his son looking on from the car, he decided he was willing to try anything — even an experimental therapy that created an electromagnetic field around his brain.

What Tony and several other former U.S. Special Operations Forces personnel received Newport Brain Research Laboratory, located at the Center, was a new treatment for brain disorders, one that might just revolutionize brain-based medicine. Though the FDA clinical trials to judge its efficacy and risks are ongoing, the technique could help humanity deal with a constellation of its most common mental disorders — depression, anxiety, aggressiveness, attention deficit, and others—and do so without drugs. And if its underpinning theory proves correct, it could be among the biggest breakthroughs in the treatment of mental health since the invention of the EEG a century ago.

At the lab, Tony (whose name has been changed to protect his identity) met Dr. Erik Won, president and CEO of the Newport Brain Research Laboratory, the company that’s innovating Magnetic EEG/ECG-guided Resonant Therapy, or MeRT. Won’s team strapped cardiac sensors on Tony and placed an electroencephalography cap on his skull to measure his brain’s baseline electrical activity. Then came the actual therapy. Placing a flashlight-sized device by Tony’s skull, they induced an electromagnetic field that senta small burst of current to his brain. Over the course of 20 minutes, they moved the device around his cranium, delivering jolts that, at their most aggressive, felt like a firm finger tapping.

For Tony, MeRT’s effects were obvious and immediate. He walked out of the first session to a world made new. “Everything looked different,” he told me. “My bike looked super shiny.”

He began to receive MeRT five times a week— each session lasting about an hour, with waiting room time — and quickly noticed a change in his energy. “I was super boosted,” he said. His mood changed as well.

Today, he admits that he still has moments of frustration but says that anger is no longer his “go-to emotion.” He’s developed the ability to cope. He still wants help with his memory, but his life is very different. He’s taken up abstract painting and welding, two hobbies he had no interest in at all before the therapy. He’s put in a new kitchen. Most importantly, his sleep is very different: better.

Tony’s experience was similar to those of five other special-operations veterans who spoke with Defense One. All took part in a double-blind randomized clinical trial that sought to determine how well MeRT treats Persistent Post-Concussion Symptoms and Post-Traumatic Stress Disorder, or PTSD. Five out of the six were former Navy SEALS.

[…]

All said that they saw big improvements after a course of therapy that ran five days a week for about four weeks. Bill reported that his headaches were gone, as did Cathy, who said her depression and mood disorders had lessened considerably. Jim’s memory and concentration improved so dramatically that he had begun pursuing a second master’s degree and won a spot on his college’s football team. Ted said he was feeling “20 years younger” physically and found himself better able to keep pace with the younger SEALS he was training. All of it, they say, was a result of small, precisely delivered, pops of electricity to the brain. Jim said the lab had also successfully treated back and limb pain by targeting the peripheral nervous system with the same technique.

[…]

The lab is about one-third of the way through a double-blind clinical trial that may lead to FDA approval, and so Won was guarded in what he could say about the results of their internal studies. But he said that his team had conducted a separate randomized trial on 86 veterans. After two weeks, 40 percent saw changes in their symptoms; after four weeks, 60 did, he said.

“It’s certainly not a panacea,” said Won. “There are people with residual symptoms, people that struggle…I would say the responses are across the board. Some sleep better. Some would say, very transformative.” (Won doesn’t even categorize the treatment as “curing,” as that has a very specific meaning in neurology and mental health, so much as “helping to treat.”)

[…]

The separate notion that electricity could be used to treat mental disorder entered wide medical practice with the invention of electroconvulsive therapy, or ECT, in Italy in the 1930s. ECT — more commonly called shock therapy — used electricity to induce a seizure in the patient. Its use spread rapidly across psychiatry as it seemed to not only meliorate depression but also to temporarily pacify patients who suffered from psychosis and other disorders. Before long, doctors in mental institutions were prescribing it commonly to subdue troublesome patiets and even as a “cure” for homosexuality. The practice soon became associated with institutional cruelty.

In the 1990s, a handful of researchers, independent of another, realized that electricity at much lower voltages could be used to help with motor function in Parkinson’s patients and as an aid for depression. But there was a big difference between their work and that of earlier practitioners of ECT: they used magnetic fields rather than jolts of electricity. This allowed them to activate brain regions without sending high currents through the skull. Seizures, it seemed, weren’t necessary.

In 2008, researchers began to experiment with what was then called transcranial magnetic stimulation to treat PTSD. Since then, it’s been approved as a treatment for depression. Won and his colleagues don’t use it in the same way that doctors do when they’re looking for something simple and easy to spot, like potential signs of a seizure or head trauma. Won uses EEG/ECG biometrics to find the subject’s baseline frequency, essentially the “normal” state to return her or him to, and also to precisely target the areas of the brain that will respond to stimulation in the right way.

YOU Have a Signature. Your Signature is YOU

No two people experience mental health disorders in the same way. Some PTSD sufferers have memory problems; others, depression; still others, uncontrollable anger. But people that are diagnosed with depression are more likely to suffer from another, separate mental health issue, such as anxiety, attention deficit, or something else.

The theory that underpins MeRT posits that many of these problems share a common origin: a person’s brain has lost the beat of its natural information-processing rhythm, what Won calls the “dominant frequency.”

Your dominant frequency is how many times per second your brain pulses alpha waves. “We’re all somewhere between 8 and 13 hertz. What that means is that we encode information 8 to 13 times per second. You’re born with a signature. There are pros and cons to all of those. If you’re a slower thinker, you might be more creative. If you’re faster, you might be a better athlete,” Won says.

Navy SEALS tend to have higher-than-average dominant frequencis, around 11 or 13 Hz. But physical and emotional trauma can disrupt that, causing the back of the brain and the front of the brain to emit electricity at different rates. The result: lopsided brain activity. MeRT seeks to detect arrhythmia, find out which regions are causing it, and nudge the off-kilter ones back onto the beat.

“Let’s just say in the left dorsal lateral prefrontal cortex, towards the front left side of the brain, if that’s cycling at 2 hertz, where we are 3 or 4 standard deviations below normal, you can pretty comfortably point to that and say that these neurons aren’t firing correctly. If we target that area and say, ‘We are going to nudge that area back to, say, 11 hertz,’ some of those symptoms may improve,” says Won. “In the converse scenario, in the right occipital parietal lobe where, if you’ve taken a hit, you may be cycling too fast. Let’s say it’s 30 hertz. You’re taking in too much information, oversampling your environment. And if you’re only able to process it using executive function 11 times per second, that information overload might manifest as anxiety.”

If the theory behind MeRT is true, it could explain, at least partially, why a person may suffer from many mental-health symptoms: anxiety, depression, attention deficits, etc. The pharmaceutical industry treats them with separate drugs, but they all may have a similar cause, and thus be treatable with one treatment. That, anyway, is what Won’s preliminary results are suggesting.

“You don’t see these type of outcomes with psychopharma or these other types of modalities, so it was pretty exciting,” he said.

There are lots of transcranial direct stimulation therapies out there, with few results to boast of. What distinguishes MeRT from other attempts to treat mental disorders with electrical fields is the use of EEG as a guide. It’s the difference between trying to fix something with the aid of a manual versus just winging it.

If the clinical trials bear out and the FDA approves of MeRT as an effective treatment for concussion and/or PTSD, many more people will try it. The dataset will grow, furthering the science. If that happens, the world will soon know whether or not there is a better therapeutic for mood and sleep disorders than drugs; and a huge portion of the pharmaceutical industry will wake up to earth-changing news.

But there’s more. Won believes that MeRT may have uses for nominally healthy brains, such as improving attention, memory, and reaction time, as Ted discovered. It’s like the eyesight thing, the sudden, stark visual clarity. “These were unexpected findings, but we’re hearing it enough that we want to do more studies.”

Performance enhancement is “not something that we’re ardently chasing,” says Won. ”Our core team is about saving lives. But so many of our veterans are coming back asking.”

Already, there’s evidence to suggest that it could work. “What we’ve noticed in computerized neuro-psych batteries is that reaction times improve. Complex cognitive processing tasks can improve both in terms of speed to decision and the number of times you are right versus wrong. Those are all things we want to quantify and measure with good science,” he says.