For a physiotherapist, the physical ailments for which people seek help for mental health and well-being can be complex and challenging to address. Mental health and mental well-being are influenced by biological, psychological, and social factors. This article focuses on tips for addressing biological and psychological determinants of mental health. Though I'm not a physiotherapist myself, I'm lucky to have a physiotherapist as a fiancée, and so have some insight into general stressors that physiotherapists face.

I've also done some research into this important subject and would like to share my insights.

According to the World Health Organization (WHO), health is defined as “…a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Mental health is, therefore, an important pillar of overall health, being defined as “… a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

Social determinants of mental health such as economic, cultural, and political factors, though significant in their potential effect on mental health and well-being, are beyond the scope of this blog post. Instead, I offer five tips to help reduce stress and improve overall mental well-being.

1. Observe your own mind

The best way to reduce stress is to remove or mitigate the impact of stressors in our lives that cause mental distress in the first place. There are two kinds of problems in life - those that we can influence or have some degree of control over, and those that we have no control over. Being a self-advocate and taking steps towards reducing or removing problems in your life that cause you stress is an important tool for improving mental health.

No life is without stress and not all stressors can be removed. Stressors in life are like small holes in a boat that gradually let in water. These holes are harmless until the boat starts to sink - and this, like in life, is generally when we realize there's a problem. Stress relief techniques can be thought of like a bailer bucket - stress can be removed, but if the root cause is not addressed, before long you'll feel like you're sinking again.

Identifying the root cause of psychological detriments to our mental health is hard work. This is because it requires us to direct our conscious attention towards observing our own mind, which is the very thing that produces our consciousness to begin with. Don't worry, this isn't as difficult as it sounds!

Some problems have obvious causes, while others are more like grit covered by a hardened pearl of thoughts, feelings, and emotions that have layered over time. In the latter case, isolating the root cause takes deep inner reflection. For problems that you have no control over, remember that you still have a degree of control over how you react to those problems.

The practice of observing our own mind is called meditation and is an excellent tool for ‘looking under the hood’ of our own thought processes and observing what's going on. The more it's practiced, the more detail can be seen, and the more can be understood – the ‘why’ and ‘how’ of our thoughts, feelings, and emotions.

2. Accept your healthy limits

According to the The Maslach Burnout Inventory Manual, burnout is a syndrome characterized by three components: emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. 

Creating a treatment plan for your cases while at the same time giving motivational energy and helping your patients cope with the emotional components of their ailments can be mentally and emotionally taxing. Without stress relief, or if the working conditions are such that the physiotherapist can't give their patients the time they need, over time this can lead to burnout for the physiotherapist. 

Emotional exhaustion is the first sign of burnout. Burnout is correlated with aspects of personal dysfunction, such as physical exhaustion, insomnia, or marital and family conflicts. Don't let an issue that started at work affect your quality of life in your personal time.

If you're experiencing emotional exhaustion from work, don't hesitate to talk to your colleagues or employer if you feel that your working conditions are contributing to your burnout. Accept your limits! Remember that you're human and that your best is good enough. If you feel that you're giving everything that you have, but it still isn't enough, then there's something else at play. Learn to recognize when you're pushing yourself beyond healthy limits and don't be afraid to ask for help. If you're feeling this way, then your colleagues may be feeling this way too.

3. Take an exercise break

Exercise can help relieve stress by making us feel better through the release of 'feel-good' hormones. Exercise also has overall anti-inflammatory effects that help protect brain health. According to a meta-analysis study, individuals who engaged in regular exercise had a 22% reduced risk of developing depressive symptoms than their sedentary cohorts. 

Aside from the biological effects of exercise, exercise can also provide a sort of psychological ‘escape’ from stress, especially through sports or activities that require active focus. Taking this break from everyday life can give our minds the time needed to passively put life stressors in perspective. Often, problems will appear less stressful after taking an exercise break than they were before.

4. MANAGE YOUR CASELOAD TO MAKE TIME FOR PAPERWORK

Most physiotherapists would agree that the most rewarding aspects of being a physiotherapist are doing assessments, interacting with patients, and watching patients improve over time and get back to their normal way of life. Taking on more cases allows you to hone your skills and have a thriving practice, but it's important to allot time in your day for charting and paperwork so that you can maintain the work-life balance that's right for you. Having reliable estimates of the actual time spent with each patient, for treatment and charting combined, will give a realistic impression of how many hours you'll need to work per day, and help you decide how to manage your caseload. Setting up designated times for paperwork, either between patients or at the end of the day, can help avoid the stress associated with the feeling that your work is taking time away from your personal life.

5. RELISH YOUR REST

Getting adequate sleep is important for maintaining mental well-being. The body responds to sleep deprivation by increasing the release of stress hormones. Being tired reduces your ability to focus, which can negatively impact your performance at work and/or your interactions with friends and family. This in turn can lead to more stress. If you're having trouble falling asleep, or feel like you're not getting enough sleep, then you might find these tips on sleep.org helpful.

Stress is inevitable in life, but the good thing is there are many concrete things that can be done to reduce the impact of stressors on mental health and our quality of life. Mindfulness and meditation are useful tools for identifying the root causes of stress in life so that we can take deliberate action against them. At work, being aware of physiotherapist burnout and managing your caseload in the way that's right for you can help relieve stress. Outside of work, taking the time to exercise and getting adequate rest are two other ways of reducing stress. Last but not least, if your stress is negatively impacting your life in a way that you can't control, it's important to ask for help and take advantage of the resources that are available to you.

ADDITIONAL RESOURCES:

• Brain Mind for stress relief
• For sleep support visit sleep.org
  
• Neurovine's Meditation Program