11 Engaging in a Healthy Lifestyle

Healthy Eating

While it’s not the only thing that contributes to great health, what you eat makes a huge difference. We have 37 trillion cells in our body. The only way they function optimally is with good nutrition. As a college student, you will be surrounded by temptations to eat poorly or even to overeat. It’s now up to you to make wise choices in the face of these temptations. Your dining hall is likely full of many healthy foods and just as many unhealthy foods. You may grab food on the run while racing to class or order a pizza at midnight while studying for a test. Lobby vending machines or a stash of snacks in your room should not turn into a substitute for real meals. The downside of fast food and easy access treats is that many are loaded with sugar, salt, or both.

The United States Department of Agriculture (USDA) updated their Healthy Plate Guidelines in 2011. MyPlate illustrates five different food groups considered the building blocks for a healthy diet—vegetables, fruits, protein, grains, and dairy.

Figure 11.2 Eating healthy is a journey shaped by many factors, including our state of life, situations, preferences, access to food, culture, traditions, and the personal decisions we make over time. The USDA recommends that vegetables and fruits make up the largest portions of your diet, and dairy the smallest portion. All your food and beverage choices count. MyPlate offers ideas and tips to help you create a healthier eating style that meets your individual needs and improves your health. (Credit: USDA / Public Domain)

It’s also important to know what is not a healthy plate. A healthy plate is low in refined carbohydrates (donuts, pastries, pasta, cookies), low in sugar, and low in saturated fat (although we need healthy fats like avocado and nuts). You can learn more at https://www.myplate.gov/.

While the USDA’s MyPlate was revised to reflect some key findings at that time, nutritionists at Harvard felt it didn’t offer the most complete picture when it comes to basic nutrition guidelines. They created The Healthy Eating Plate, which is based on what they consider to be the best available science. Similar to MyPlate, half the plate is vegetables and fruit. Aim for eight servings of veggies or fruits a day, more veggies than fruits. It’s important to note that the Harvard version was created without the political pressure from food industry lobbyists (for example, the dairy industry). Note that grains are further defined as whole grains, protein is now healthy protein, and water is emphasized over dairy/milk. What other differences do you see?

This table provides more detail on how The Healthy Eating plate compares to USDA’s MyPlate.

Healthy eating also includes choosing organic fruits and vegetables when possible. By choosing organic, you help lower the amount of toxins your body encounters (since conventional fruits and vegetables are often sprayed with pesticides). Organic foods may not be readily available on your campus or in your local grocery store, so strive to choose the best options possible given availability and your budget. Many college and universities are adding organic food as a result of student demand. If healthy eating is something you are passionate about, consider organizing an effort to influence the dining options on your campus. When shopping on your own, the Dirty Dozen list provided by the Environmental Working Group (EWG) is a good guide of which produce is most important to eat organic, as these are the fruits and vegetables with the most pesticide residue. The EWG also compiles a Clean 15 list of the vegetables and fruits with the least amount of pesticides.

How to Read a Food Label

The U.S. government requires food manufacturers to put a label on every processed food product. This is so we, as consumers, know what we are putting into our bodies and can make good dietary choices. A quick review of the label will provide a lot of important information about what you are eating, yet most people don’t take the time to read the label. This is a big mistake.

Think of the front of the package as a marketing billboard. Don’t be fooled by the marketing. Every day millions of dollars are spent to persuade us to eat foods that are not healthy for us. Through visuals (like the strawberry on the bottle of dressing below) and words (like natural, healthy, or gluten free), the food industry wants us to make assumptions about the nature of a food product without looking at the facts. For example, many people eat protein bars thinking they are a healthy choice, but protein bars can have up to 30 grams of sugar! Understanding the nutrition information and ingredients will help you make healthier choices. When you take the time to read the labeled ingredients, you are no longer being marketed to—you are staring at the facts.

Figure 11.3 This label displays the key nutritional information about a common container of fruit salad. Though fruit is generally healthy, be aware of the amount of calories and sugars, and particularly the serving size to which those amounts are tied. Note that the US government has updated food label requirements and this version of the label will soon be the only one you’ll see. (Credit U.S. Food and Drug Administration / Public Domain)

Look at the label on the back of what appears to be a healthy item: fruit salad or fruit cocktail. One of the first things to look for is the amount of sugar. 12 grams equals just under 2.5 teaspoons. The serving size indicated is 2/3 cups, so if you have double that amount, it’s the equivalent of spooning out 5 teaspoons of sugar. The lower the sugar the better.

It’s also important to avoid high amounts of sodium, to minimize saturated fats, and to avoid all trans fats. Trans fats are unhealthy substances made through the process of solidifying liquid oils to increase the shelf life of foods. Also called partially hydrogenated oil, trans fats are often found in margarine, microwave popcorn, crackers, cookies, and frozen pizza. Saturated fat usually comes from animal products like butter and meat fat. Saturated fat tends to raise the level of cholesterol in the blood, and while some is OK, moderation is best.

Dietary fiber is a good thing; the higher the number the better. Fiber has virtually no calories, but it holds water in your stomach, makes you feel full, and helps with digestion. Vitamins are very important. Aim to get to 100 percent of your recommended daily value through the food you eat throughout the day.

Next, look at the ingredient list that can be found at the bottom of the nutrition label. A long list of ingredients likely contains fillers and preservatives you should avoid. If you can’t pronounce an ingredient, you can generally assume it is not a healthy option. And it’s not only what you eat, it’s what you don’t eat. As a rule, the fewer the ingredients, the better.

This video on how to read a food label is a helpful overview on what else to look for.

You can also download the Fooducate app, which allows you to scan the bar code of any food item and quickly see a report card and suggestions for healthier alternatives.

Analysis Question

Take a few minutes to write down everything you ate in the last two days. Now review your list and estimate what percent of your food intake came from whole foods. How did your meals compare to The Healthy Plate? Where is there opportunity for healthier choices? How can these changes benefit you?

What You Drink

What is your go-to drink when you are thirsty? Soda? Juice? Coffee? How about water? Most of your blood and every cell in your body is composed of water. In fact, water makes up 60 to 80 percent of our entire body mass, so when we don’t consume enough water, all kinds of complications can occur. To function properly, all the cells and organs in our body need water. Proper hydration is key to overall health and well-being. By the time you feel thirsty, you are already dehydrated. Dehydration is when your body does not have as much water and fluids as it needs. Researchers at Virginia Polytechnic discovered that mild dehydration (as little as losing 1 to 2 percent of body water) can impair cognitive performance.4 Water increases energy and relieves fatigue, helps maintain weight, flushes toxins, improves skin complexion, improves digestion, and is a natural headache remedy (your brain is 76 percent water). Headaches, migraines, and back pains are commonly caused by dehydration. Your body will also let you know it needs water by messaging through muscle cramps, achy joints, constipation, dry skin, and of course a dry mouth.

Aside from feeling thirsty, the easiest way to tell if you are dehydrated is to check your urine. If it is a dark shade of yellow, your urine is over-concentrated with waste. This happens because water helps flush out waste and when you’re hydrated there’s a higher ratio of water to waste, turning your urine a lighter color.

One of the best habits you can develop is to drink a large glass of water first thing in the morning. Your body becomes a little dehydrated as you sleep. Drinking water first thing in the morning allows your body to rehydrate, which helps with digestion and helps move the bowels for regularity in the morning. It also helps to eliminate the toxins your liver processed while you slept.

Check out this video for more benefits of drinking water.

Staying hydrated is important to keep your body healthy, energized, and running properly. As a general guideline, aim to drink eight glasses of water a day, although a more helpful guide is to drink half your body weight in ounces (for example, if you weigh 150 lb, try to drink 75 oz of water a day). One of the best ways to remind yourself to drink throughout the day is to buy a reusable bottle and bring it everywhere you go. There are two reasons to use a refillable water bottle instead of a plastic bottle:

1. Your own health. Most plastic water bottles have a chemical called bisphenol A (BPA), which is added to plastics to make them more durable and pliable. BPA is known to disrupt hormones and has been linked to sperm dysfunction.
2. The health of the planet. Do you know that every time you drink from a plastic water bottle and casually toss it in the trash, it can stay on the planet approximately 450 years?5 Even when you recycle, the complex nature of recycling doesn’t guarantee your plastic bottle will make it through the process. Americans purchase about 50 billion water bottles per year, averaging 13 bottles a month for each of us. By using a reusable water bottle, you can save an average of 156 plastic bottles annually.6
   5
   https://www.telegraph.co.uk/news/2018/01/10/stark-truth-long-plastic-footprint-will-last-planet/
   6
   https://www.earthday.org/2018/03/29/fact-sheet-single-use-plastics/#_ftn5

“But I don’t like the taste of water!” It may take time, but eventually you will. Add a little more each day, and eventually your body will feel so fantastic fully hydrated that you will have water cravings. In the meantime, you can visit the dining hall in the morning and add lemon, lime, berries, watermelon, cucumbers, or whatever taste you enjoy that will add a little healthy flavor to the water.

While water is undeniably the healthiest beverage you can drink, it is unrealistic to assume that is all you will drink. Be careful to minimize your soda intake, as most sodas are loaded with sugar or artificial sweeteners (which can be even worse than sugar). And unless you are squeezing your own fruit juice, you are also likely drinking a lot of sugar. Many fruit juices sold in supermarkets contain only a small percentage of real fruit juice, and have added sugar and other unhealthy sweeteners like high-fructose corn syrup. A 12-oz glass of orange juice can contain up to 9 teaspoons of sugar, about the same as a 12-oz can of Coke! Hot or cold herbal teas are a wonderful addition to your diet.

Exercise

Many people exercise to maintain or lose weight, or increase cardiovascular health, but physical outcomes are only one potential benefit of exercise. Regular exercise can improve the quality of your sleep, strengthen your bones, increase your energy levels, and reduce your risk of high blood pressure, diabetes, and even some forms of cancer.7 Regular exercise is key to living a long, healthy life.

There are three basic types of exercise—flexibility, strength training, and cardiovascular.

1. Flexibility is the range in motion of the joints in your body, or the ability for your muscles to move freely. Without adequate flexibility, daily activities can become difficult to do. Stretching increases your body’s flexibility, improves circulation, and sends more blood to your muscles. Just a few minutes a day of deep stretching can have a powerfully positive impact on your health. Yoga and Tai Chi are other wonderful ways to improve your flexibility.
2. Strength is the body’s ability to produce force. Strength training helps improve muscle strength and muscle mass, which will become increasingly important as you age. Increased muscle helps your body burn calories more efficiently. Strength training also helps maintain bone strength. In addition to lifting weights, other ways to build strength include push-ups, pull-ups, squats, lunges, and yoga.
3. Cardiovascular is the body’s ability to use oxygen efficiently during exercise. As one’s ability to use oxygen improves, daily activities can be performed with less fatigue. Great cardiovascular modes of exercise include jogging, swimming, biking, and HIIT (high intensity interval training). HIIT is short bursts of intense activity followed by a rest period. With HIIT, you can squeeze a lot of benefit into a short period of time. Click here for an example of HITT workouts.

Figure 11.4 Your college may offer a variety of unique and interesting exercise programs and classes, which you can take advantage of to learn new things and stay fit. (Credit: Jo Allebon / Flickr / Attribution 2.0 Generic (CC-BY 2.0))

Research indicates that regular aerobic exercise can support memory and cognition. In these studies, aerobic exercise generally increases the number of new neurons created in the brain’s memory center and also reduces inflammation.8 Inflammation in the brain may contribute to the development of dementia and other neurodegenerative conditions. It might be good timing to take a jog before you sit down to study for a test!

It’s important to move throughout the day, and every day. Aim to exercise for 150 minutes a week. You don’t have to be the king or queen of CrossFit; it’s the daily movement that is most important. While it is best to integrate all three types of exercise, the best exercise is the one you will actually do. Find and commit to a form of exercise you will enjoy.

Toxins

We live in an increasingly toxic world. Since the Industrial Revolution, we have released thousands of man-made chemicals into the environment. These chemical toxins are in our food (pesticides, conventional fertilizers), in food packaging, in household products, and in our personal care products. Many of these chemicals have been linked to infertility, asthma, migraines, ADHD, and cancer.

The complicated thing about these chemicals is that their effects can take years or even decades to appear. The chemicals build up over time and they interact with each other, which can result in problems that are not considered by “single chemical” testing (which is the majority of the limited testing that is done).

Now the good news—there are simple things you can do right now to limit the amount of toxins in your environment. First, it is best to avoid any products with “artificial colors” or “fragrance.”

• Artificial colors: Synthetic dyes like Yellow 10, Blue 1, and Red 28 may contain carcinogens and neurotoxins and can be absorbed by your skin and go directly into your bloodstream.
• Fragrance: Have you ever walked down the cleaning and laundry soap aisle and been assaulted by so many fragrances you couldn’t get to the next aisle fast enough? Claiming trade secrets, companies don’t have to tell us what’s in “fragrance,” which can include highly toxic ingredients, hormone disruptors, and carcinogens. Fragranced products come in the form of soaps, cleaners, air fresheners, hand sanitizers, laundry detergents, and personal care products. Studies have repeatedly shown that the synthetic fragrances and other toxic chemicals included in these products are causing a range of health problems.9
  9
  https://www.ewg.org/

There is a long and ever-growing list of common chemicals to avoid, but it’s hard to remember the names when you are shopping. That’s where a handy app like Healthy Living from the EWG comes in.

Simply scan the bar code of any products you use and learn about any potential health hazards.

“Many Americans are surprised to learn that the ingredients in their makeup, shampoo and body lotion are largely unregulated and, in some cases, harmful to their health. The fact is that companies can put potentially dangerous ingredients into the products they sell without ever having to prove they are safe.”

— Heather White, Environmental Working Group Executive Director

Your skin is your largest organ, and in seconds will absorb what you put on it. It’s important to be wary of conventional skin care products that could potentially leak toxins into your body. Think of your skin as one giant mouth. If you wouldn’t eat the ingredients in your products, think twice before applying them to your skin.

What Happens When We Sleep?

Sleep is a time when our bodies are quite busy repairing and detoxifying. While we sleep we fix damaged tissue, toxins are processed and eliminated, hormones essential for growth and appetite control are released and restocked, and energy is restored. Sleep is essential for a healthy immune system. How many colds do you catch a year? How often do you get the flu? If you are often sick, you do not have a healthy immune system, and sleep deprivation may be a key culprit.

A review of hundreds of sleep studies concluded that most adults need around eight hours of sleep to maintain good health. Some people may be able to function quite well on seven and others may need closer to nine, but as a general rule, most people need a solid eight hours of sleep each night. And when it comes to sleep, both quantity and quality are important.

When sleep is cut short, the body doesn’t have time to complete all the phases needed for the repair and detoxification.

A tiny lobe called the pineal gland helps us fall asleep. The pineal gland secretes melatonin to calm the brain. The pineal gland responds to darkness. If you are watching TV until the minute you go to bed and then sleep with the artificial light from smartphones and other devices, your brain is tricked into thinking it is still daylight; this makes it difficult for the pineal gland to do its job. In addition, if the TV shows you watch before bed are violent or action-packed, your body will release cortisol (the stress hormone). Anything that creates stress close to bedtime will make it more difficult to fall asleep. A bedtime practice of quiet activities like reading, journaling, listening to music, or meditation will make it much easier to fall asleep.

What Happens If You Don’t Get Enough Sleep?

Lack of sleep has a big impact on your overall state of health and well-being. Studies have linked poor sleep to a variety of health problems. The U.S. Centers for Disease Control and Prevention have identified sleep deprivation as a public health epidemic.

A lack of sleep can change the way your genes express themselves. One notable study involved a group of healthy adults limited to six hours of sleep for one week. Researchers then measured the change in gene activity compared to the prior week when these same people were getting a full eight hours of sleep a night. The lack of sleep caused the activity of 711 genes to become distorted. About half of the genes were switched off by a lack of sleep, and these genes were associated with the immune system. The other half of the genes experienced increased activity from a lack of sleep, and these were genes associated with the promotion of tumors, genes associated with long-term chronic inflammation, and stress genes.12

Figure 11.5 The Effects of Sleep Deprivation This visual depicts many of the ways we are affected by insufficient sleep. (Credit: Häggström, Mikael (2014). "Medical gallery of Mikael Häggström 2014". WikiJournal of Medicine. Public Domain.)

Some of the health risks of insufficient sleep include the following:

Increased risk of heart attack and stroke: In his book Why We Sleep, Matthew Walker, PhD, shares Japanese research showing that male workers who average six hours of sleep or less are 400 to 500 percent more likely to suffer one or more cardiac arrests than those getting more than six hours of sleep each night. Another study of women between the ages of 20 and 79 found that those who had mild sleep disturbance such as taking longer to fall asleep or waking up one or more times during the night were significantly more likely to have high blood pressure than those who fell asleep quickly and slept soundly.13

Impaired cognitive function: Even one night of sleeping less than six hours can impact your ability to think clearly the next day.

Increased risk of accidents: Sleep deprivation slows your reaction time, which increases your risk of accidents. You are three times more likely to be in a car crash if you are tired. According to the American Sleep Foundation, 40 percent of people admitted to falling asleep behind the wheel at least once. A Governor’s Highway Safety Association report estimates there are 6,400 fatal drowsy driving crashes each year. Fifty percent of these crashes involve drivers under the age of 25.14

Figure 11.6 Driving while drowsy puts you, your passengers, and many others in danger. (Credit: Modification of work by Governors Highway Safety Association.)

Driving after 20 hours without sleep is the equivalent of driving with a blood-alcohol concentration of 0.08 percent—the U.S. legal limit for drunk driving.

Weight gain/increased risk for obesity: Sleep helps balance your appetite by regulating hormones that play a role in helping you feel full after a meal. Also, cortisol is released during times of anxiety, and exhaustion causes your body to produce more cortisol. This can stimulate your appetite.

Increased risk of cancer: Tumors grow up to three times faster in laboratory animals with severe sleep dysfunctions. Researchers believe this is because of disrupted melatonin production, as melatonin has both antioxidant and anticancer activity.

Increased emotional intensity: The part of the brain responsible for emotional reactions, your amygdala, can be 60 percent more reactive when you've slept poorly, resulting in increased emotional intensity.

For more information on the advantages and health risks of sleep watch this TED Talk by Matt Walker, PhD, Director of the Sleep Center at U California Berkeley.

Tips to Improve the Quality of Your Sleep

Now that you are more aware of the ways insufficient sleep harms your body, let’s review some of the things you can do to enhance your sleep.

Make sleep a priority.

It can be challenging in college, but try to get on a schedule where you sleep and wake at the same time every day to get your body accustomed to a routine. This will help your body get into a sleep rhythm and make it easier to fall asleep and get up in the morning.

Sleep in a cool, quiet, dark room.

Create a sleeping environment that is comfortable and conducive to sleep. If you can control the temperature in your room, keep it cool in the evening. Scientists believe a cool bedroom (around 65 degrees) may be best for sleep, since it mimics our body's natural temperature drop. Exposure to bright light suppresses our body’s ability to make melatonin, so keep the room as dark as possible. A 2010 study in The Journal of Clinical Endocrinology & Metabolism found that individuals exposed to room light “during the usual hours of sleep suppressed melatonin by greater than 50%.”15 Even the tiniest bit of light in the room (like from a clock radio LCD screen) can disrupt your internal clock and your production of melatonin, which will interfere with your sleep. A sleep mask may help eliminate light, and earplugs can help reduce noise.

Avoid eating late or drinking alcohol or caffeine close to bedtime.

It is best to finish eating at least two hours before bedtime and avoid caffeine after lunch. While not everyone is affected in the same way, caffeine hangs around a long time in most bodies. Although alcohol will make you drowsy, the effect is short-lived and you will often wake up several hours later, unable to fall back to sleep. Alcohol can also keep you from entering the deeper stages of sleep, where your body does most of the repair and healing. A 2013 Scientific Research study concluded that “energy drinks, other caffeinated beverages and alcoholic beverages are risk factors of poor sleep quality.” It’s important to finish eating hours before bedtime so your body is able to heal and detoxify and it is not spending the first few hours of sleep digesting a heavy meal.

Start to wind down an hour before bed.

There are great apps to help with relaxation, stress release, and falling asleep. Or you can simply practice 4-7-8 breathing to calm your nervous system—breathe in to the count of 4, hold your breath for a count of 7, and release your breath slowly to the count of 8.

Consider the Insight Timer app, or any of the free apps listed by the American Sleep Association.

Exercise for 30 minutes a day.

One of the biggest benefits of exercise is its effect on sleep. A study from Stanford University found that 16 weeks in a moderate-intensity exercise program allowed people to fall asleep about 15 minutes faster and sleep about 45 minutes longer. Walking, yoga, swimming, strength training, jumping rope—whatever it is, find an exercise you like and make sure to move your body every day.

Improve your diet.

Low fiber and high saturated fat and sugar intake is associated with lighter, less restorative sleep with more wake time during the night. Processed food full of chemicals will make your body work extra hard during the night to remove the toxins and leave less time for healing and repair.

Sleep affects how we look, feel, and function on a daily basis and is vital to our health and quality of life. When you get the sleep your body needs, you look more vibrant, you feel more vibrant, and you have the energy to live your best life.

Now, with a better understanding of the benefits of getting the recommended hours of nightly sleep and the health risks of not getting enough sleep, what changes can you make to improve the quality and quantity of your sleep?

What If I’m Doing All These Things and I Still Have Trouble Sleeping?

People that have trouble falling asleep also often have low magnesium levels (sources suggest that over half of the adults in the United States are magnesium deficient). You can ask your doctor to check your magnesium levels, but you can also focus on eating magnesium-rich foods to help. One of the best magnesium-rich snacks is pumpkin seeds. Other great sources are almonds, sesame seeds, and walnuts.

Difficulty sleeping may be a sign that you have a clinical sleep problem, such as insomnia or sleep apnea. If you are doing all the right things and still have trouble falling or staying asleep, talk to your doctor.

These are some resources for insomnia:

• Healthy Sleep, Harvard Medical School Division of Sleep Medicine
• Insomnia Treatment, American Association of Sleep Medicine
• Sleep Medicine, Society of Behavioral Sleep Medicine

Identifying and Managing Stress

According to a 2018 report from the American College Health Association, in a 12-month period 42 percent of college students reported that they have felt so depressed it was difficult to function, and 63 percent reported feeling overwhelming anxiety.16 Your ability to manage stress, maintain loving relationships, and rise to the demands of school and work all impact your emotional health.

Stress is not always bad. In fact, some stress is helpful. Good stress is stress in amounts small enough to help you meet daily challenges. It’s also a warning system that produces the fight-or-flight response, which increases blood pressure and your heart rate so you can avoid a potentially life-threatening situation. Feeling stressed can be perfectly normal, especially during exam time. It can motivate you to focus on your work, but it can also become so overwhelming you can’t concentrate. It’s when stress is chronic (meaning you always feel stressed) that it starts to damage your body.

Mindfulness and Gratitude

Deep breathing, mindfulness, and a practice of gratitude are some of the most effective ways to manage stress and take care of your emotional health.

Gratitude

Too often people think it is the external factors that bring us joy and happiness, when really it’s all related to internal work. According to UCLA’s Mindfulness Awareness Research Center, “Having an attitude of gratitude changes the molecular structure of the brain, and makes us healthier and happier. When you feel happiness, the central nervous system is affected. You are more peaceful, less reactive and less resistant.”21

21

2016 Study Journal of PLoS One, https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316

Numerous studies show that people who count their blessings tend to be happier and less depressed. In a UC Berkeley study, researchers recruited 300 people who were experiencing emotional or mental health challenges and randomly divided them into three groups. All three groups received counseling services. The first group also wrote a letter of gratitude every week for three weeks. The second group wrote about their thoughts and feelings with negative experiences. The third group received only counseling. The people in the group who wrote gratitude letters reported significantly better mental health for up to 12 weeks after the writing exercise ended.

This would suggest that a healthy emotional self-care practice is to take note of good experiences or when you see something that makes you smile. Think about why the experience feels so good. According to Rick Hanson, author of Resilient, “Each day is strewn with little jewels. The idea is to see them and pick them up. When you notice something positive, stay with the feeling for 30 seconds. Feel the emotions in your whole body. Maybe your heart feels lighter or you’re smiling. The more you can deepen and lengthen positive experiences the longer those positivity neurons in your brain are firing—and the longer they fire the stronger the underlying neural networks become. Repeat that process a half dozen times a day and you’ll feel stronger, more stable and calmer within a few weeks.”

Figure 11.7 Do you have a stress toolkit filled with a variety of stress-coping tools to help you navigate any stressful situation? (Credit: Modification of work by Robin Benzrihem)

Activity

Take a look at some of the suggested tools for your stress toolkit. Which ones have you tried? Have they been effective in helping you manage stress? Ask two friends or family members about their favorite stress-management strategies. What has worked for you and others that is not on this list? Identify two new tools you would like to explore and articulate how you will determine if they work for you, and then you can confidently add them to your stress toolkit.

What Is Mental Health?

Mental health is “the level of psychological well-being or an absence of mental illness. It is the state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment.”22

According to NAMI (National Alliance on Mental Illness), a mental illness is a condition that affects a person's thinking, feeling, or mood. The condition may affect a person’s ability to relate to others and function throughout the day.

A mental health condition isn’t the result of one event; it is most often the result of multiple overlapping causes. Environment, lifestyle, and genetic predisposition can all be factors in whether someone develops a mental health condition. Traumatic life events or stressful experiences may make some people more susceptible, and brain biochemistry may play a role as well. Mental health conditions show up in many ways. Anxiety, depression, and eating disorders are some of the most common.

Self-Care

Healthy relationships start with healthy individuals. Self-care is learning to take good care of yourself and to prioritize your own needs. Self-care involves any activity that nurtures and refuels you, such as taking a walk in the woods, going to a yoga class, attending a sporting event, reading a good book, or spending time with friends. When you are feeling calm and nourished, you are going to look forward to your day, and despite how busy it is, you will prioritize time with friends and family. If you don’t take care of and learn to love yourself, you will never be able to bring your best self to any relationship.

An important dynamic you bring to any relationship is how you feel about yourself. Self-esteem is about loving yourself and being happy for who you are. Building healthy self-esteem impacts how you see yourself, which can drastically improve your relationships. While low self-esteem won’t keep us from romantic love, it can act as a barrier to a healthy relationship. If you do not believe you are good enough, how can you expect your partner to think so?

When you feel secure in yourself, this allows you and your partner to feel more secure about the relationship. If you have insecurities, it may show in your relationship as jealousy, defensiveness, or tension that leads to unnecessary arguments. Healthy self-esteem goes hand in hand with self-confidence, and feeling confident about yourself will translate into a stronger and more satisfying relationship. If you are experiencing low self-esteem, you may give your partner too much credit or stay in a relationship that is not healthy for you. If you find yourself changing your personality for someone else, that is never a sign of a healthy relationship.

You can reverse negative self-talk and build your self-esteem. If you catch yourself thinking you are unlovable, unattractive, or not good enough, it’s important to start talking to yourself in a positive way and to celebrate all that is uniquely you.

Self-care includes self-forgiveness. We all make mistakes. A misstep isn’t the end of the world. Pick yourself up, put things in perspective, acknowledge any lessons to be learned, focus on all that makes you special, and move forward. Be kind to yourself.

The Importance of Community

The Nicoya Peninsula in Costa Rica is home to some of the highest number of centenarians (people who are 100 years old or older) in the world. Costa Ricans in general report a high level of life satisfaction. Dan Buettner, author of the Blue Zones study of the longest living populations in the world, explains that Costa Rica “is a place where religion, family, and social interaction are the main values, unlike trying to get ahead, or financial security, or status. Their cities are set up so they’re bumping into each other all day long. They walk to the markets, where they have conversations with people.”26

In many families in Costa Rica, multiple generations live together under the same roof or nearby where they can be involved in each other’s lives. Neighbors are like extended family, and people often stop in for a visit and go out of their way to help one another.

While this isn’t the way many of us live in the United States, the lessons from the Blue Zone study underscore the importance of community and the health benefits of connecting to and staying close to a community. What communities do you belong to? Is your dorm a community? A sports team? A club or people you volunteer with? When you start seeing the social circles you connect to as communities and prioritize your time to develop more closeness with those communities, you will experience many physical, mental, and emotional health benefits.

Figure 11.12 Joining clubs in college can be an outstanding way to join and build communities. (Credit: SupportPDX, Cerritos College / Flickr / Attribution 2.0 Generic (CC-BY 2.0))

According to an analysis of research on college students (Joe Cuseo, The Most Potent, Research-Based Principles of College Success), college students who have a higher sense of belonging and are more involved in their college community are more successful. Additionally, college students who are involved in extracurricular, volunteer, and part-time work experiences outside the classroom (less than 20 hours per week) earn higher grades than students who do not get involved in any out-of-class activities at all.

Research has shown that friends provide a sense of meaning or purpose in our lives, and that having a healthy social life is important to staying physically healthy. In a meta-analysis of the research results from 148 studies of over 300,000 participants, researchers found that social relationships are important in improving our lifespan. Social support has been linked to lower blood pressure and better immune system functioning. The meta-analysis also showed that social support operates on a continuum: the greater the extent of the relationships, the lower the health risks.27

According to a 2018 report from the American College Health Association, in a 12-month period, 63 percent of college students have felt very lonely. If you are feeling lonely or having a hard time making friends, know that the majority of people around you have also felt this way. Joining a group or a club of people who share your interests and passions is one of the best ways to make great friends and stay connected.

Sexual Health

Affection, love, and sexual intimacy all play an important role in healthy relationships, and a responsible approach to intimacy is essential for sexual health. Whether you are already sexually active or become sexually active in the future, your choices can affect your safety as well as the health and safety of your sexual partners. It’s important to understand what you can do to protect yourself from sexually transmitted infections (STIs).

How You Can Protect Yourself against STIs

The surest way to protect yourself against STIs is to practice abstinence. This means not having any vaginal, anal, or oral sex. There are many things to consider before having sex, and it’s okay to say no if you are not ready. If you do decide to have sex, you and your partner should both get tested beforehand and make sure you always use a condom. It’s not safe to stop using condoms unless you’ve both been tested, know your status, have another form of birth control, and are in a mutually monogamous relationship. Mutual monogamy means that you and your partner both agree to only have sexual contact with each other. This can help protect against STIs as long as you’ve both been tested and know you’re STI-free. Visit this website to find a confidential STI testing location near you.

Before you have sex, talk with your partner about how you will prevent STIs and pregnancy. If you think you’re ready to have sex, you need to be ready to protect your body and your future. You should also talk to your partner ahead of time about what you will and will not do sexually. Your partner should always respect your right to say no to anything that doesn’t feel right. Sex should always be consensual and respectful.

It’s important to discuss treatment with your doctor and begin treatment as soon as possible if you find out you have an STI. If you are living with an STI, it’s important to tell your partner before you have sex. Although it may be uncomfortable to talk about your STI, open and honest conversation can help your partner make informed decisions to protect his or her health.

Safety Consciousness

To be safety conscious means you have an awareness of potential hazards and an alertness to danger. Simply, you are conscious of being safe. This includes being smart about your physical surroundings and careful with drug and alcohol use.

A drug is a chemical substance that can change how your body and mind work and how you feel. Some drugs are illegal (like cocaine or heroin), and while others may be legal, they can still harm your body and brain. Even prescription medicines can be abused when taken to get high or to a point of dependency.

Why do people abuse drugs? The answer varies for different people, but most want to feel good and escape any bad feelings they are experiencing. Or they want to improve in an area of their life—for example, to get better grades. This may lead them to start taking drugs for more energy, to stay awake longer, or to stay focused while studying. This short-term boost is not worth the health risks and the potential for addiction.

Personal Safety

For many students, their first year in college is also the first time they have lived away from home, or for commuting students, often the most time they have spent away from home. This new freedom can feel really exciting. College should be a time for fun, experimentation (in healthy ways), and growth. It’s important to be smart about your safety and conscious that you don’t put yourself in any high-risk situations. It’s also important to know what to do if any problems arise. Here are some ways to remain safe while enjoying your college experience:

1. Speak up. If you are worried about a friend’s well-being, ask them if they are OK. If you see inappropriate behavior, let someone know. Get an RA or other authority involved if someone looks like they are in trouble or an activity looks like it is leading to trouble. In general, speak up if you notice something going on that concerns you.

2. Learn your campus emergency system. Many colleges and universities have blue-light phones with direct access to campus security. If your campus has blue-light phones, take the time to find out where they are. If you are not familiar with the emergency system on your campus, visit your public safety department (or website) to understand how you can call for help in an emergency. Add campus security to your phone contacts.

   

   Figure 11.13 Emergency phones and related systems are present on many campuses. Learn your system and note the locations of these devices as you travel. If you commute via public transportation, such as a train or bus, learn the safety procedures and devices available for those systems. (Credit: KOMO News / Flickr / Attribution 2.0 Generic (CC-BY 2.0))

3. Protect your drink. A risk at bars and at college campus parties is the use of date-rape drugs to assist sexual assaults. Date-rape drugs often have no color, smell, or taste, so you can’t tell if you are being drugged. The drugs can make you weak and confused so you are unable to refuse sex or defend yourself.

   It is easy for anyone to slip a date-rape drug in your drink. Never leave your drink unattended, and never accept a drink from someone you do not trust.

4. Be alert and stay charged. Always be aware of the people in your surrounding area. Notice anyone who looks out of place, and avoid dark and unpopulated areas. Make sure to charge your cell phone before you go out for the evening.

5. Avoid walking alone at night, and don’t accept rides from strangers. Going out with a group is the best way to make sure everyone gets home safely. In the event you find yourself alone at the end of the night, know ahead of time what escort services your school offers. Or use services like Uber and Lyft, and MAKE SURE you get in the car that matches the license plate on the app.

   It’s also wise to install safety apps. These apps can automatically alert police and your emergency contacts in the event of an emergency. Always let your roommates and friends know your plans for the evening and when you expect to return.

If You Are a Victim of Sexual Assault or Rape

Sexual assault is any type of sexual activity you don’t agree to. This can include inappropriate touching, sexual intercourse, attempted rape, and rape. Most people are surprised to learn that 80 percent of rapes are committed by someone the victim knows.

Figure 11.14 The majority of rapes are committed by people known to the victim, which can have a significant effect on prevention and reporting. (Credit: Modification of work by RAINN)

Take the following steps if you or someone you know has been raped:

• Get medical care. Go to the nearest rape crisis center, hospital, or student health service center. Do not go to the bathroom, shower, brush your teeth, wash your hands, or change clothes before you go. It’s important to preserve any evidence.
• Ask the hospital or center to take a urine sample to test for date-rape drugs.
• Call the police from the hospital. Tell the police exactly what you remember. File a report.
• Arrange for follow-up counseling. A counselor can help you work through the many emotions you may feel following a sexual assault, which is important to the healing process. You can get help from the National Sexual Assault Hotline at 800-656-HOPE.

Under Title IX legislation, sexual harassment and sexual violence are forms of gender discrimination and are prohibited. This includes off-campus incidents or incidents that involve people who are not students. If you experience a hostile environment, sexual harassment, or sexual assault, schools have a responsibility to stop the discrimination, prevent its recurrence, and address its effects. Schools also have a responsibility to protect people who report sexual harassment or assault from retaliation from other students, school administrators, or faculty.

The Clery Act, a federal law that intersects with Title IX, requires colleges and universities to do the following for survivors of campus sexual assault:

• Notify survivors of counseling resources.
• Notify survivors of the option to report a case to the school and law enforcement.
• Provide requested accommodations, such as changing dorms or classes.
• Notify survivors of the final outcome of a disciplinary proceeding.