A Psychiatrist in the Woods

How I Discovered the Health Benefits of Nature

Read time 12 minutes – 2500 words

Nature and Medical Education

I am a psychiatrist – and someone who frequently spends time in nature – although I didn’t learn about the mental health benefits of nature through my medical training.

If you are trying to find a mental health professional like a psychiatrist you are unlikely to find them in a forest, you may be lucky to spot one having lunch in a city park where they are likely trying to find some respite from their clinical work. Likewise, if you are a mental health professional you won’t have much luck opening a successful clinic in a national park (at least not at this time).

While mental health treatments and health promotion and the natural outdoor environment don’t intersect frequently, there are important relationships between exposure to nature and improved mental health and wellbeing. Increasing our time in nature – whether in an indoor, urban, rural or wilderness environment – can help in reducing stress, increase a sense of well-being and help people recover from mental health disorders.

Algonquin Park, Ontario, Canada

Most people could do with more nature in their life – in Canada 87% of people acknowledge that spending time in nature is associated with increased happiness. However, when we look at how much time most people spend in nature 29% of Canadians spend less than 30 minutes weekly in nature and 64% spend less than 2 hours.

I didn’t learn about the mental health benefits of nature through medical school, residency training in psychiatry or my academic work towards obtaining my PhD.  Medical training teaches an approach to diagnosis – a reasoning process to arrive at the “cause” of an illness or symptoms. Once a diagnosis has been reached then evidence-based treatments can be applied to the illness to alleviate or relief symptoms.

The medical model works well (sometimes) for discrete acute illnesses with known causes and treatments, the infections, heart attacks and broken bones of the medical system. This approach also works for many individuals with mental illness, often the right medication or psychotherapy – or both – can alleviate symptoms and improve functioning.

I haven’t thrown away my prescription pad for hiking boots yet – there is an important role for the medical approach to treating mental illness. I strongly believe that if you or a loved one has a severe disabling mental illness, treatment in collaboration with a psychiatrist, psychologist or other mental health clinician is likely going to be an important part of getting well and we as a society should do more to reduce the stigma associated with mental illness and treatment.

Galatea Trail, Alberta, Canada

Medical school ill prepares physicians – even psychiatrists with specialized training in mental health – to help people with more common problems of daily stress and less than optimal quality of life. For these situations there is no medication that is going to alleviate these problems (I’m sure multinational pharmaceutical companies have tried – there ongoing research to try to cure aging).

However, if you wait long enough – a life of stress and poor habits can contribute to the development of a significant mental illness or worsen symptoms of a psychiatric disorder if one already exists.

I see this frequently among my patients – and also my colleagues in health care (physicians and other health care professionals have some of the highest rates of stress of any profession and its become a crisis in our profession). Spending time in nature regularly has been a highly effective strategy for me to improving my quality of life and the research evidence I will share on Nature Brain will demonstrate that even relatively short periods of time in nature can have lasting beneficial effects.

Nature and Mental Health

Every person needs a foundation health psychological practices and habits in order to enjoy their lives and relationships fully, and to decrease their chances of developing both psychiatric and medical illnesses. Several strategies or tools are available to all of us that may help in this regard – meditation and exercise in particularly have substantial evidence.  

Regular interactions with nature is another practical strategy that can also improve psychological well-being. The regular practice of activities involving nature, exercise, and practice of meditation are what I consider the “triad” or “holy trinity” of psychological self-care.

The biggest barrier to implementing these practices for most people is motivation; and the great thing about nature is that it is probably involves the least effort of these three practices. Activities based in nature can also incorporate aspects meditation and exercise as well making nature particularly effective and efficient way to improve one’s mental health.

Chester Lake, Alberta, Canada

Interactions with nature are sometimes referred to as Ecotherapy or Nature Therapy although I will “therapy” out of most of my discussions unless I am referring to a specific structured facilitated interaction with nature that has a specific psychological or mental health outcome intended – and to not medicalize the health benefits of nature. I will review the evidence for Nature Therapy or Ecotherapy in subsequent posts which can be beneficial for many individuals.

However, there are practical aspects related to limited access to therapists, potential costs associated with therapies (particularly therapies which are not considered “evidence-based” and unlikely to be covered by insurance plans), and the stigma associated with seeking out help that will make these type of nature related therapies limited in terms of its potential impact at a population level.

Most individuals who interact with nature are not going to be following a prescribed treatment or therapy, rather it will involve a self-directed journey and involve the development of habits and routines to increase their time in nature. Sharing the benefits of nature and practical strategies and tools for increasing opportunities to interact with nature are part of what I hope to accomplish with Nature Brain.

Integrating Nature in My Life

My interest in the mental health benefits of nature followed somewhat opposite path to discovery compared to my work as a scientist. My understanding of benefits of nature has been like that of the old-schools physicians we learned about in medical school – one based on careful personal observations of patterns over time garnered from repeated exposures to situations, coupled with rudimentary experiments to test hypotheses and confirm some truth underlying these observations.

I grew up in a rural community and being outside was part of our culture. Many of our families worked or lived on farms, the distances between our homes made it necessary to travel outside to socialize, and many of our hobbies involved being outdoors. Over time I gravitated towards larger and larger cities for school and work opportunities and gradually a both a busier lifestyle and changing personal priorities led to less and less time outdoors (I’m not alone, 2/3 of Canadians spend less time in nature now than as children).

About halfway through my psychiatry residency training I gradually started to shift towards a healthier lifestyle giving up smoking, being more mindful of what I was eating – and for the first time in my adult life – I started spending time outdoors running. Initially running through the wooded area near my apartment was a challenge but the sensations that came from running along forested trails or along Lake Ontario made me feel reconnected with my body and with nature.

Lake Ontario, Ontario, Canada

The relaxation that followed running was an immediate boost to my mental health. Gradually over time – and numerous running injuries – my outdoor activities shifted towards cycling. First riding on the gravel trails around my home in Kingston, Ontario and eventually taking on road cycling through the beautiful countryside surrounding southern Ontario.

Both cycling and running were primarily outdoor activities for me although I participated in activities inside when weather or circumstances required it. The fitness aspects of indoor exercise were evident, however the psychological benefits of these activities performed indoors wasn’t the same as being outdoors.

Being outdoors – particularly in natural environments largely away from buildings and other people – brought additional benefits to exercise. Over time I started spending more time cycling on the road gradually increasing my distances and exploring different terrains including rural gravel trails, and thus began my personal practice of integrating nature into my life on a consistent basis. Over time, the relationship between activities outdoors and daily stress became evident to me – regardless of the physical intensity of the activity.

K & P Trail, Kingston, Ontario

Hooked On Nature

Over time I have sought out different opportunities and activities involving nature. I came to appreciate the variety of natural environments around Kingston, Ontario where I lived for 14 years. Kingston is a small city in southern Ontario and it is a great place for people who love the outdoors.

Kingston is situated on Lake Ontario, near the origin of the St. Lawrence River (the 1000 Islands region). The city has plenty of green space and nearby nature conservation areas (Lemoine Point and Little Cataraqui Conservation area). A short ferry ride across Lake Ontario brings you Wolfe Island. Kingston has a very active outdoor community and the secondary roads around Kingston provided me endless opportunities for cycling in rural settings.

I also came to appreciate the opportunities for walks in nature and hiking in places like Gould Lake and Frontenac Park just north of Kingston. While there were many benefits to working at Queen’s University and living in Kingston, having easy access to outdoor activities was something that I realized was going to be important priority for me in my life regardless of where I lived.

I’ve always been drawn to water (water seemed so exotic growing up in the dry prairie of rural Saskatchewan) and Kingston also provided me with the opportunity to explore nature on the water. I bought a small recreational kayak. I started spending my early weekend mornings during the summers kayaking the small lakes around Kingston. The small Canadian shield lakes around Frontenac park provided a peaceful retreat in nature.

Gould Lake, Ontario, Canada

Frequently I would be the only person on South Otter Lake for hours at a time. The sounds of nature on the water – waves washing on to the shore, trees creaking in the wind, small animals scrambling over leaves – were one of my favorite sensations from my time on the water. Kayaking also provides a unique perspective on nature, much of the time we enjoy the view of the water from land. For me being on the water also comes with a feeling of being literally out of one’s element.

I recently moved from Kingston to Calgary, Alberta in the fall of 2019 to pursue both professional opportunities to explore new avenues of research in my academic career. Calgary was also a great fit on a personal level – it is a large city of close to 1.5 million people but also in close proximity to the amazing outdoor environment of the Rocky Mountains.

Access to hiking, snowshoeing and cross-country skiing are available within 45 minutes of Calgary and slightly further afield in Kananaskis, Canmore, Banff and Lake Louise provide what seem to be limitless opportunities for outdoor activities. I now try to spend at least one day each weekend (and two if I’m lucky) outside exploring near trails and areas which leaves me feeling recharged on Monday mornings to begin my work week.

Ribbon Creek, Alberta, Canada

As I learned more about Ecotherapy and the benefits of nature that can also come from shorter periods of time in urban nature environments I have been incorporating more nature related activities into my work week. I include 30 minute nature activities during the work week – usually walking in a nearby park – along with longer excursions on the weekend that are more physically active.

In some upcoming posts I’ll review the evidence about the weekly “dose” of nature that seems to be associated with improved health – I personally aim for at least three days where I participate in nature related activities and a minimum of 120 minutes of nature activities per week.

My Discovery of “Ecotherapy”

Only recently have I come to appreciate the growing scientific evidence linking human interactions with nature and improvements in well-being and mental health. While I had periodically heard media stories about the health benefits of nature in the news – and knew other people who regularly connected with nature – it never occurred to me that there was an academic field studying the health benefits of nature.

One day I was on my way to the staff cafeteria at Providence Care Hospital and had to run the gauntlet of tables that were frequently set up there knowing that we all had to traipse past them to get coffee or paninis. I usually look at these tables and smile at the people selling cheese as a fundraiser for an arts program at the hospital or will read some materials about whatever “week” is being celebrated.

This time the presenter – Jillian who worked in the spiritual care department got me with her pitch “Would you like to take a quiz about Ecotherapy?”. You had me at quiz! The word Ecotherapy also captured my attention and I took and failed the polite 4-question quiz about Ecotherapy.

Jillian told me about how our forensic mental health program (an assessment and treatment program for individuals who have mental health problems and have come in contact with law enforcement) was providing a weekly Ecotherapy group for patients involving walking through nature on the hospital grounds.

This immediately made sense to me and Jillian provided the titles of some books related to Ecotherapy which started me on my journey of understanding the evidence linking nature and to mental health.

Nature Brain

Now that I’ve been personally convinced of the benefits of nature I ensure that I get a minimum of a couple hours of nature in each week – often a few walks along the river in Calgary during the work week and a couple longer “sessions” in the mountains on the weekends. One idea I had recently after snowshoeing was to combine two of my passions in life – nature and mental health, following a recent snowshoe trip to Rawson Lake in the Kananaskis.

Hence was born Nature Brain – a place for people to share their experiences with nature and for all of us to learn more about the benefits of nature and share strategies for integrating more nature in our lives.

Rawson Lake, Alberta, Canada

My goal in starting Nature Brain is to share scientific evidence, resources, my personal experience and strategies to help people integrate experiences with nature in their daily lives in order to improve their psychological health.

For most people learning practical strategies and practices to increase their meaningful interactions with nature will begin with small personal decisions and activities practiced on their own or with close friends and families, after such foundational work and practice some people may want to dive deeper into Ecotherapy with additional training or experiences.

On Nature Brain I will provide information about the mental health benefits of nature, provide practical strategies to incorporate nature practices into individuals daily lives, and create a community of individuals who share a similar belief and interest in furthering their connection with nature for the psychological benefits this can provide.

I’ll plan to post longer content (not usually this long!) on specific topics related to nature and mental health every few weeks along with shorter posts about nature locations, news about nature, reviews of books and movies, and tips and my own activities.

I hope you enjoy Nature Brain – It’s humans, nature!

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