Overview

I will provide a summary of the background for reading this book, impressions after reading it, and noteworthy points along with practical actions that can be implemented in daily life.

NOTE: I read the Japanese edition, and the sentences are translated from Japanese by ChatGPT.

Background

People in our immediate surroundings, including relatives, friends, and colleagues, often face mental health issues. Personally, I have experienced mental health challenges several times in the past. The global interest in mental health seems to have increased significantly with the outbreak of COVID-19.

In Japan, the number of psychiatric outpatient visits is high even when compared to other countries, with a substantial number of patients seeking treatment.

Reference: http://www.npo-jam.org/library/materials/dl/j_usa_gb.pdf

It's also common to hear that Japan has a higher suicide rate compared to other countries.

Reference: https://www.mhlw.go.jp/content/r1h-1-10.pdf

While it's challenging to attribute these issues solely to cultural or religious differences, everyone agrees that there is room for improvement. Given the seriousness of these problems, mental health care systems are gradually being introduced, particularly in Japanese companies and schools.

However, it seems that counseling culture and the concept of self-management are not yet widespread in Japan. Specifically, in terms of care within families, there is still a long way to go. Personally, even though these issues are so close to home, I had never really taken the time to learn about mental health care.

Impressions

Recently, when I stopped by a bookstore, I happened to come across the book "Why Has Nobody Told Me This Before?" and it seemed promising, so I bought and read it. It was exactly what I had wanted to know! I was impressed by its content.

In this book, various methods for maintaining mental health in different situations are described based on scientific evidence.

What struck me the most is the idea that to maintain mental health, one needs to proactively understand and control their mental state on a daily basis. Instead of casually dismissing it with statements like "I'm healthy, so it's fine" or "I'm sick, so there's nothing I can do," it requires continuous effort and attention to take care of one's mental health over time. It made me realize the importance of acquiring and practicing skills to maintain mental health independently, not being influenced by others. Even if you currently have no issues, investing in your future mental health through self-control and learning these skills is crucial.

Throughout the book, it emphasizes the importance of factors like diet, sleep, exercise, and journaling.

Overview of the Book

The book is divided into chapters, each addressing different situations and providing background information, perspectives, and skills to deal with them. The chapters cover:

• When you're feeling down
• When you lack motivation
• When you're trapped in negative emotions
• When you've lost something important
• When you've lost confidence
• When you're feeling anxious
• When you're stressed
• When you're feeling unfulfilled

Below, I'll quote and summarize the points that left a strong impression on me.

1. When You're Feeling Down

Cross-Sectional Analysis

The book explains that the causes of feeling down aren't always in the mind but can also be related to physical condition, relationships, past and present, lifestyle, and more. Every aspect of what you do or don't do can contribute to these feelings.

To understand why you're feeling down, start by reflecting on your experiences. Spend time breaking down your experiences from a particular day, and with practice, you'll become more aware of the various aspects involved in your emotions. This awareness can provide an opportunity to make changes in your situation.

Develop the habit of thinking back on moments when you felt down, which will make it easier to identify the aspects contributing to your mood.

One valuable tool for organizing your thoughts is "Cross-Sectional Formulation," which helps you analyze thoughts, emotions, actions, and physical sensations related to a specific experience. This understanding can reveal how you get caught in a cycle of feeling down and how to break free from it. Additionally, creating an analysis diagram of when you're feeling good can help you identify actions to achieve desired emotions.

Psychology Tools Cross-Sectional Formulation

Recognizing Cognitive Biases

Various cognitive biases, such as mind-reading, overgeneralization, self-centered thinking, emotional reasoning, mental filtering, "should" statements, and all-or-nothing thinking, can worsen your mood. To address these biases, you need to become aware of them when they arise.

To become aware of cognitive biases, it's beneficial to reflect on your thoughts when you're feeling calm. Select specific moments (both positive and negative) and distinguish your thoughts, emotions, and physical sensations at that time. After listing your thoughts, check them against a list of biases to see if they were present.

Mindfulness is also helpful for gaining perspective on your thoughts. It allows you to observe your thoughts without judgment and is a scientifically supported practice. While mindfulness is often associated with meditation, the book also mentions that you can practice it during activities like walking, brushing your teeth, or taking a shower.

Meta-Cognition

Meta-cognition refers to the ability to think about your thoughts, stepping back from them to understand their nature. You can't control the thoughts that pop into your head, but you can control what you do when they appear.

Physical Movement

When trying to change your mood, it's challenging to do it solely in your head. Many people find that physical movement can help them shift their feelings.

Connection with Others

When negative emotions spiral out of control, the most potent tool to push them out of the stage is connecting with others. People act as mirrors, reflecting your emotions and increasing self-awareness. Observing, interacting, and building connections with others can elevate your mood and bring you back to the real world from the mental turmoil.

People who keep their struggles to themselves often believe that showing their less-than-best selves would burden those around them. However, science suggests otherwise. Social support benefits not only the recipients but also the providers. Don't wait until you feel like meeting people; take action first. Your mood will follow suit. Spending more time with people will contribute to improving your mental health.

When spending time with others, you don't necessarily have to reveal your own feelings. Just being around people, observing them, and offering a smile can suffice.

If you can't find quality and safe relationships among family and friends, don't hesitate to seek help from professionals.

Gratitude Habit

Write down three things you're grateful for once a day. It doesn't matter if they're significant, like the presence of a loved one, or small, like enjoying a cup of coffee in the morning. Every time you express gratitude, your brain practices focusing on positive aspects. With practice, you'll find it easier to do the same in other situations. What you choose for those three things doesn't matter; the key is to consciously focus on gratitude.

Treat Yourself as You Would Treat Loved Ones

Just as you would uplift and encourage loved ones, speak to yourself with warmth and kindness.

Prioritize the Basics

When feeling down, people tend to neglect their daily routines first. They become distant from friends, overindulge in coffee, have trouble sleeping, and stop exercising. For example, new parents may experience sleep deprivation due to their baby's nighttime crying. While you can't control the baby's crying, you can take care of yourself by paying attention to your diet, maintaining contact with friends and family, and ensuring you survive this period.

Exercise increases the concentration of dopamine in your bloodstream and the number of dopamine receptors in your brain. In other words, exercise enhances your ability to experience joy in daily life. While exercise has the reputation of being a strenuous process for changing one's appearance, you can start with simple, enjoyable activities like dancing until you're slightly out of breath and gradually increase them.

Lack of sleep almost inevitably leads to feeling down and losing confidence in your ability to recover. If you believe you're not getting enough sleep, it's well worth investing time and effort to improve it. Your circadian rhythm is regulated by exposure to light. Get plenty of sunlight within 30 minutes of waking up in the morning. Even on cloudy days, being outdoors is essential. Spend as much time as possible outside during the day. In the evening, reduce screen brightness, and turn off electronic devices as early as possible.

For those who tend to worry as soon as their head hits the pillow at night, create a worry list. This list will turn into a to-do list for the next day. By promising yourself to address those concerns with dedicated time tomorrow, you can focus on falling asleep without dwelling on your worries.

Scientifically, a healthy diet has been shown to prevent depression associated with aging.

2. When You Lack Motivation

Action Comes First

Motivation isn't something that naturally occurs; it needs to be generated through action. If you do nothing, your spirit will run out of fuel, and feelings of lethargy or "it's too much trouble" will intensify. Motivation is a byproduct of action, and it wells up not when you're heading to the gym, but when you're coming back from it.

Even when you're feeling down and thinking, "I can't muster up the motivation to do anything," starting something can induce biological and emotional changes within yourself.

Maintain a Goal Diary

Observing and recording what you are trying to accomplish over time is crucial, as it makes it easier to feel motivated more frequently. Take a minute at the start of each day to list one or two things you should do that day to achieve your goals. At the end of the day, reflect on what you did and write a few lines about it. By doing this every day, you take responsibility for your actions and keep your focus on your goals.

Break Tasks into Smaller Steps

To establish new habits, start with small things and gradually build them up one by one. When your motivation for long-term goals wanes, small rewards can be helpful. These are intrinsic rewards, recognizing the value of your effort and praising yourself for trying.

Establish Habits

The best strategy for boosting motivation is to remove motivation from the equation. Whether you have motivation or not, you have things you do every day. For example, brushing your teeth in the morning.

Balancing Effort and Rest

On any given day, there should be quiet, somewhat dull moments between working hard and making efforts. During these times, instead of deleting emails, scrolling through social media, or tackling small tasks, take the opportunity to rest and recharge your body and mind. If you have 15 minutes of downtime between meetings, instead of reaching for your smartphone, go outside for some fresh air or spend some time with your eyes closed.

DBT (Dialectical Behavior Therapy)

Thinking about a desirable future is beneficial, but thinking about an undesirable future is also valuable. In DBT therapy, the benefits and drawbacks of maintaining the status quo and actively working toward change are carefully considered. This exercise can be helpful in times when you're on the verge of giving up on improving your life or straying from your path. Keeping a diary and constantly reviewing your reactions while working on change is highly recommended.

Develop the Power of Recording and Reflecting

When you want to make significant changes, start by keeping records. Cultivate the ability to look back on your experiences and how you dealt with them. By paying attention to details, you can gain a deeper understanding of past experiences and eventually become more aware of your behavior patterns and cycles in the moment.

3. When You're Trapped in Negative Emotions

Accepting Emotions and Their Impact

Instead of trying to erase emotions, change your relationship with them. Pay attention to your emotions, acknowledge them, accept them, and learn to influence them and control their intensity. You can't summon emotions as you desire, but you can influence them. Take responsibility for your happiness and learn new ways to experience your emotions.

Question Your Emotions

When negative emotions well up, approach them with curiosity and ask questions. Learn from your emotions with curiosity. Write down your thoughts and stories.

Expand Your Vocabulary for Expressing Emotions

Expanding your vocabulary for expressing emotions and discerning subtle differences in emotions allows you to control your emotions and choose beneficial responses in social situations. Research shows that people with limited concepts and words to distinguish negative emotions tend to experience more intense feelings of depression when under stress.

When you feel something, try to express it more specifically, not just as "good" or "bad."

Reference: https://www.visualcapitalist.com/a-visual-guide-to-human-emotion/

Self-Soothing

Self-soothing refers to a series of actions to create a feeling of safety and comfort when experiencing negative emotions. This can include having a warm beverage, chatting with a trusted friend or loved one, physical activity, listening to music, looking at beautiful images, taking slow breaths, or using scents and perfumes associated with safety and comfort. If you can't bring yourself to talk to someone when you're not feeling like it, processing your emotions by writing can help you gain a clearer understanding of what's happening.

Keep a Diary

Recording positive emotions, thoughts, and memories in a diary helps create pathways to those desired emotions and experiences. By reinforcing these paths, you make it easier to access those emotions.

Supporting Loved Ones

Many people with mental health issues don't want to be told what to do but appreciate when someone cares and checks in on them regularly. Supporting someone isn't about having tense, serious conversations. For the person receiving support, even a momentary sense of connection with others is crucial. Be there when you're needed most.

4. When You've Lost Something Important

Understanding the Stages of Grief

Grief has stages: denial, anger, bargaining, depression, and acceptance.

Express Yourself

Find someone you trust to talk to about your grief. If talking is difficult, write about it. In any form, expressing your thoughts and feelings helps you understand what's happening in your mind and body.

Seek Professional Support

Overcoming the pain of grief often requires support, but not everyone has someone they can trust or open up to. In such cases, therapy can become a sanctuary where you can safely release your raw emotions.

5. When You've Lost Confidence

Feel the Fear of Feeling Fear

To build confidence, it's crucial to feel the fear of taking important actions. Feeling confident in something feels good, and it can make you want to stay there and maintain the status quo. However, staying in your comfort zone won't allow you to grow further. To build confidence, you need to deliberately step into areas where you lack confidence. Facing your fears and uncertainties is what builds confidence. Learn to coexist with fear.

What's Needed to Step into the Stretch Zone

There are three zones: the comfort zone, the stretch zone, and the panic zone. Stepping into the stretch zone requires acknowledging that you can improve with effort. It also requires enduring a period of feeling powerless.

List Situations Where You Want to Have More Confidence

List situations where you want to have more confidence. Write the most intimidating situation at the top of the list, followed by situations that are less intimidating but still challenging below it. Even if they seem difficult, start with something you think you can manage and repeat that action as much as possible. Once you gain confidence in that situation and it becomes your comfort zone, move on to the items at the top of the list.

Self-Acceptance Is Necessary for Growth

Research shows that those who accept their mistakes and have compassion for themselves are less afraid of failure, more willing to try again after failing, and gradually build confidence. To foster self-acceptance, you first need to understand who you are and who you want to be. It starts with self-awareness and introspection. Keeping a diary, seeking therapy, and talking to friends can all encourage introspection and help you reflect on yourself and your experiences.

Strengthen Your Compassionate Side

To strengthen your compassionate side, practice being compassionate in your daily life. Write a compassionate letter to yourself. Write it as if it were intended for your best friend who is struggling to change. By confronting your compassionate side and thinking about various ways to show compassion, you can build the emotional muscles you need for when you need them.

6. When Feeling Anxious

Don't Let Fear Dominate

Every time we say "no" to something out of fear, we reinforce the belief that "it's not safe" or "I can't handle it." Each time we detach something from our lives due to fear, our life becomes a little narrower. Trying to escape from fear today will eventually lead to allowing fear to dominate our life choices in the long run. If you don't want to feel anxious about something, try to do it as frequently as possible. By doing so, you'll learn to coexist with anxiety, and over time, the anxiety will decrease.

Relieve Anxiety through Breathing

Excessive anxiety can lead to rapid breathing as the body tries to take in extra oxygen to fuel the fight-or-flight response. For example, inhaling during a count of 7 and exhaling during a count of 11 can be an effective immediate anxiety-relief technique.

Exercise

Anxiety responses are the body's way of preparing for fight or flight, so when they occur, muscles become filled with oxygen and adrenaline, making you ready to act quickly. On stressful days, consider doing short jogging outdoors or spending about 30 minutes hitting a punching bag. Exercise releases physical stress from your body, making you feel calm and more relaxed afterward, making it easier to sleep and recharge. Exercise can be a powerful preventive measure against anxiety, so make it a part of your routine even on anxiety-free days.

Express Thoughts Objectively

To distance yourself from anxiety, express your thoughts objectively. When you want to see your emotions or situations from a new perspective, write down everything you're thinking and feeling. Reviewing what you've written can be a powerful way to process and understand your experiences from a bird's-eye view.

Accept Death

The fear of death has been claimed to underlie many mental health issues. We try to protect ourselves from the constant threat of death by taking actions that provide a sense of security and fulfillment in life. Accept the certainty of death as a part of life and the uncertainty of when and how it will come. Thinking about what you would write on your tombstone with just a few lines is a good task to explore what you value. It can become the meaning you want to live your life by from today. Moreover, writing about the theme of death can be useful for exploring the fear of death because it allows you to distance yourself from it and calm your mind without interrupting insights or thought processes. You can stop at any time and resume writing when you're mentally prepared.

7. When Feeling Stressed

Stress Isn't Always the Enemy

Stress doesn't necessarily bring harm, and it's not something you always have to eliminate. For instance, when you feel signs of stress before a presentation at work or a school presentation, it's actually pushing you to perform at your best. In such situations, what's required is not complete calm and relaxation but being awake and completing the task with clear thinking. Learning to raise stress levels when needed and lower them when not is the foundation of healthy stress management. Stress reflects that you're striving in line with your values, purpose, and a meaningful life.

Focus on Larger Goals Than Yourself

Considering whether your choices and efforts contribute to larger goals can reduce stress. Paying attention to whether your actions benefit others, even in small ways, can reduce stress responses even in challenging and demanding situations. When experiencing stressful events, focusing on the connection between your hardships and your values and the impact on others can make it easier to cope with stress. Changing the meaning of hardship allows you to endure stress rather than avoiding or evading it. Making your effort itself the basis of self-esteem brings about a transformation.

Practice Mindfulness

Meditation, as science has shown, has a powerful influence on brain and life quality. Most guided meditations last for about 30 minutes, but recent research has shown that even an 11-minute yoga nidra can help reduce stress, especially for those who cannot meditate for long hours. When you have strong stress and limited time, it's better to perform yoga nidra for 10 minutes than scroll through social media for 10 minutes.

Being mindful doesn't necessarily mean meditating all day surrounded by candles. It means concentrating your awareness on the present moment, observing your emotions without being carried away by them. It means not rushing to judge or hastily attribute meaning to experiences but keeping an open mind and staying curious. You can do this while walking, taking a shower, or brushing your teeth. Even if you notice your mind wandering, it doesn't mean you're failing at mindfulness.

Experience Awe

Awe is the sensation you get when confronting something beyond comprehension. Feeling your smallness in the vast universe can reduce stress, bring a new perspective, and calm your mind. When dealing with stress, it's recommended to delve into experiences that evoke awe, such as spending time with animals, being in nature, witnessing a breathtaking performance, or looking at the stars. Recording such experiences in a diary, for instance, allows you to understand their impact on you and revisit the memories, even if you can't return to the place.

Consider Stress as a Useful Strength

Instead of seeing stress responses as "problems," consider them as "useful strengths." This perspective allows you to channel your energy into tasks at hand without being drained by suppressing stress responses. Focus on using stress to concentrate on and complete the necessary tasks. Knowing that pressure can enhance performance, your actual performance can improve by 33 percent.

8. When Your Heart Feels Empty

Humans Cannot Always Be Happy

We've been led to believe that "happiness is the standard, and if you're not happy, there's a mental health problem," or "you can achieve happiness by obtaining material wealth." However, emotions are like the weather. Emotions are always in motion, changing, sometimes predictable, sometimes suddenly arising.

People with children may feel a strong sense of meaning, love, and joy in raising their children, but they also experience pain, fear, and shame. In other words, moments of happiness are like individual flowers in a large bouquet, and you can't pick out just one. Emotions come bundled together.

Review Your Values Regularly

It's essential to regularly reassess what matters most to you. When your values are unclear, you might set goals based on a sense of obligation, others' expectations, or the prediction that once you achieve it, you'll finally be satisfied and able to relax. The significant drawback of doing this is limiting the conditions for satisfaction and happiness to the future. Understanding that satisfaction and happiness in life aren't just at the destination but are found in the process of living according to your most important values is valuable. Instead of expecting to be happy in the future, consider living according to your most cherished values today, and you'll find that your life is meaningful and purposeful right now. We still need to strive for change and growth, but instead of waiting for the arrival of a meaningful life, we already have it.

Identify What Matters Most in Life

Values can change depending on life stages and the problems you face. Therefore, it's helpful to reassess your values periodically. Identify values that matter to you and are essential, such as "passion," "honesty," or "fairness." Write down how your values align with your goals and how they reflect in your daily actions. By doing this, you'll find meaning on both challenging and happy days.

Identify important areas in life such as "relationships," "health," "parenting," and so on, and rate how well you are currently aligning with your values in each area on a scale of 1 to 10. For example, if you feel that you are not prioritizing your health as much as you'd like, you can rate it as a 5.

By determining which values truly belong to you and which ones are imposed, you can understand why certain aspects of life may bring alienation rather than fulfillment.

Another way to check your values regularly is to keep a diary or engage in simple introspection.

Repeat Specific Actions Daily

Having goals alone won't change your life, and even if it does, the change may not be sustainable. What propels us in the desired direction is the specific actions we take daily. Start by carefully considering what kind of person you want to become, visualize it clearly, and translate that image into specific and sustainable actions. By making small, consistent actions a daily habit without relying on motivation or taking extreme measures, you can establish a new identity and sustain your efforts.

The Importance of Human Relationships

Healthy human relationships protect your mental and physical health throughout your life. One of the top five regrets of people facing death is "I wish I had stayed in touch with my friends more." However, there is no manual on how to maintain healthy relationships.

Couples therapy and research literature indicate that facing each other is the foundation for building deep trust. Disconnecting from yourself, your emotions, or your loved ones has a negative impact on both relationships and mental health. Yet, we are surrounded by temptations to escape from challenging relationships, whether it's scrolling endlessly through social media until our senses and thoughts are numb, immersing ourselves in work, or turning our backs on relationships to enhance our public image and strive to be seen as perfect and wealthy. None of these are truly necessary to make relationships function well.

The difficulty in relationships arises because we cannot always understand others' demands, thoughts, or feelings. However, we can understand our own. If you want to improve your relationships, start by improving yourself.

Share Meaning and Values

Choosing to share your life with someone means that values are no longer just your own problem but also involve someone else. To build a relationship that can withstand life's trials, it's essential to find and respect the different aspects of each other's values. It also leads to thinking about both your goals and the dreams of the life you'll share with your partner. In relationships and family ties, there are things that are important to both parties, things that are important to only one, and things where one adapts to the other.

Having a clear sense of what is most important to you can serve as a compass or guide when you don't know which path to take. In a relationship with a partner, taking the time to understand what matters most to them can deepen the connection and help both individuals grow and thrive.

When Should You Seek Professional Help?

In simple terms, you should seek help "whenever you feel uncertain about your mental health." In an ideal world, effective therapy would be available to those who need it when they need it. However, the real world is not always ideal. So, if you cannot access professional services, use every opportunity to learn and share with trusted individuals. Human connections and education can greatly improve mental health. To take responsibility for your health, learn as much as you can from what is available, try various approaches, and if you fail, try again, gradually increasing your knowledge and continuing to learn.

In Conclusion

The text quoted here is just a small part of the book, so if you are interested, I encourage you to purchase and read it. I believe you will find many valuable insights.

I, too, already prioritize important aspects such as diet, sleep, exercise, and more. However, this text has prompted me to consider new practices such as keeping a diary, practicing mindfulness, paying attention to my breathing, and identifying my values.

In the future, I will pay even more attention to the mental and physical health of myself and my family, and I hope to lead a healthy life in both body and mind.