Although reluctant to start on a negative note, some context around the title of this article is needed “working with mental wellbeing”. We live in uncertain times where the news is filled with gloom and doom and there are many things to worry about. If we were to avidly follow notifications on our phones and turn on the major news twice a day, we could easily become anxious, disillusioned and pessimistic about the future.
When we add this to the load created on the community by the pandemic, the concern for the economy, wars and future pandemics, it is hardly surprising that mental health is at an all-time low. The current message from Beyond Blue is that 45% of adults will experience a mental health issue in their life. Confronting stuff.
So how does that affect the work of Health and Wellness Coaches? Traditionally, we have been at the forefront of a movement that support healthy living. Living well includes what we eat, how we move, how much we sleep and how we handle stress, but when it comes to working with deeper mental issues, where is the line drawn and what do we need to know?
One thing is for sure – it’s time to up our game and acknowledge that our work has become more complex and comprehensive in terms of the issues people will bring to coaching, including around mental wellbeing.
We can do this by expanding our toolkit to encompass ways of working with people around their mental health. We can no longer draw the line between people who are mentally well and those who are mentally unwell. The reality is that like many “conditions”, mental health can start to slip slowly and the work of a Health and Wellness Coach might be to slow down this slippage and help our clients head back in the direction of mental wellness.
This does not mean that we are stepping into the role of mental health professional. We have a clear scope of practice around when to refer on, however, the lines are becoming blurred and we can no longer assume that our clients will present with happy, well-adjusted outlooks and positive mindsets. Instead, we may need to expand our knowledge around how to work with someone who is struggling with anxiety and perhaps temporary depressive mood or stress overload.
How do we do this?
We already have many tools in our toolbox that can help and may need to be brought to the forefront of our work. When a client appears to be experiencing negative effects from the way they live, or simply the world around them. This is how we can help with what we already know.
Meaning and purpose – one of the first signs that mental health is deteriorating is when people lose a sense of purpose in their lives. They may not need a mental health professional to have a conversation around this sense of purpose. They could find it in their work, or in their life generally, but current circumstances may be resulted in a loss in direction. It can be easy to forget why we are living the life we appear to have chosen that seems at times, hard and unrewarding.
Talking about what their greatest values are can help. It may be family, security, honesty, freedom, or any one of a multitude of other words that describe what they think is important. What kind of life do they want to live and what are they pursuing? Becoming clear or reconnecting with this can help in reframing their experience of their current situation. Or it may be the catalyst to make changes that have been put off through lethargy, fear or confusion. Discovering your purpose can go a long way towards avoiding burnout and keeping stress at bay.
Positive psychology embraces principles that can create awareness of what may be missing in a person’s life. Using PERMA is a great place to start. Are all of these elements in order or are some being neglected.
But is this enough – do we need more knowledge?
I believe we do. There is much to be learnt on the question of why people struggle to maintain good mental wellbeing.
A Health and Wellness Coach needs to have a good working knowledge of the symptoms of depression and know when to dig further to determine whether a client should be referred to a mental health professional. However, to do this we need to understand what factors can trigger depression.
There are obvious answers to this such as experiencing a traumatic event or loss. Sometimes this can be temporary and clinical depression may not arise. However, the biology of mental health and wellbeing is an area that ideally coaches will commit to learning more about. Needless to say, the brain plays a large part in mental health. The tendency to go straight to medication is tempting and often encouraged yet it may not be the go-to solution for many.
Various hypotheses exist as to what contributes to depression
Evidence exists that suggests that low serotonin is the main cause of depression and prescribing medication would appear to be the obvious answer to this problem. Yet we know that exercise, spending time in nature, sunlight, good nutrition, achieving goals, gratitude exercises and more can increase both serotonin and dopamine!
The important role of dopamine in our bodies is another area that warrants greater understanding by coaches – particularly, since clients often present with compulsive, addictive behaviours that may stem from this neurotransmitter which also acts as a hormone and governs much of human behaviour.
There are many excellent resources out there that can help in our understanding and ability to assess when a client needs further help and when we can support them in change. We know that talk therapy has always been valuable yet we often lean towards supporting action. Perhaps we should take a step back and hold longer, deeper conversations with our clients to truly understand their current status.
Although we are not qualified to work as mental health practitioners, we can assist and should not shy away from any hint that brain chemistry could be part of the issue. In its simplest form, wellbeing practices can affect the biology of wellbeing.
Evidence is strong to suggest that the balance of two other neurotransmitters (GABA and glutamate) is vital. The glutamate hypothesis refers to an over-abundance of glutamate which is released and directly associated with stress due to its excitatory function. If it is constantly high, a condition known as glutamate excitotoxicity can occur which creates a downward spiral in mental wellbeing. And how can we reduce glutamate? Not surprisingly –the following play a part:
• What we eat – antioxidants, vitamin D, C and B complex , omega 3 fats to name a few
• Our exercise load – modulates the balance between the two
• Sleep – being deprived causes glutamate excitotoxicity in the brain
• Cold therapy can assist in glutamate removal
• Calm – being calm and slow breathing
Are these things that fall within our normal practice? Most certainly. But knowing why they help is where the difference lies between being a good Health and Wellness Coach and one that is truly informed.
This short piece only serves as an introduction to the topic of how far does our work go. One further element of our work can be used to work in this space.
Sharing information – a Health and Wellness Coach can share information from credible sources that is evidenced based and remain working within their scope of practice. There are plenty of great essays, articles and publications out there from which we can learn and share with our clients. While we use our tried and true solutions of encouraging healthy lifestyle habits, why not share information on how certain practice affect both physical and mental health.
As a coach we are obliged to keep learning, stay curious, maintain an open mind. Clients love to learn too and they would rather commit to something that has a strong argument around its benefit and be more likely to choose that behaviour when they truly understand its value.
Fiona Cosgrove; Mast Ex Sci; Mast Counselling, NBC-HWC
Founder and Managing Director
Wellness Coaching Australia
References:
Schofield, G. (2022) The biology of mental health and wellbeing
Lieberman, D. and Long, M. (2019) The Molecule of More. BenBella Books, Inc.
https://my.clevelandclinic.org/health/articles/22581-dopamine
