The following is a condensation of a literature review by Dr. Roger Walsh.  Please review these suggested Therapeutic Lifestyle Changes (TLC).  Dr. Holzmacher believes that these scientifically derived principles for living may benefit those suffering from cognitive and emotional impairments.

(For the sake of brevity and simplicity, some of the categories listed in the original article have been compacted)


The most studied disorder in relation to exercise is mild to moderate depression.  Its therapeutic benefits compare favorably with medication and psychotherapy.  Higher intensity workouts appear to be more effective than lower intensity, but the exact guidelines for each level of intensity is unclear.

The effect of exercise on cognition is very good news.  For the young, it enhances academic performance.  For the elderly, it is an important aide to stroke recovery.  Exercise reduces geriatric memory loss, reduces the risk of Alzheimer’s Disease by 45%, and reduces the risk of other dementing conditions as well.  Exercise programs of one to three months offer significant cognitive benefits, but those lasting more than six months are more beneficial.  The benefits are even more significant if the exercise lasts more than thirty minutes, and combines both aerobic and strength training components.

ClipartDiet1Nutrition and Diet

Not surprisingly, the chemicals ingested into our body from food have a significant impact on cognitive and emotional health.  The best diet is miserably close to what our parents forced us to eat!  The diet should be rich in fruits and vegetables, contains some fish, and an eye should be kept on reducing calories.

This sort of dietary intake appears to enhance cognitive and academic performance in children, and reduce the severity of mood and psychotic disorders in adults.  There is also a reduction in age-related cognitive decline, Alzheimer’s Disease and Parkinson’s Disease.


The supplements that appear to have a real benefit on cognition and/or mood are Vitamin D, S-adenosyl-methionine, folic acid and fish oil.  The benefit appears to be the greatest with fish oil, in relatively high doses of nearly one gram per day, which entails the ingestion of multiple capsules.  The fish oil may slow the clotting of blood, such that mixing with other anticoagulants is not suggested.

In older adults, the use of fish oil reduces cognitive decline, but is not effective as a treatment for Alzheimer’s Disease.  Fish oil may also reduce aggression in children and adults, prevent the onset of psychosis in high risk youth, and have a modest benefit for those suffering with schizophrenia and Huntington’s Disease.


The psychological cost of indoor living includes disruption of mood, sleep and diurnal rhythms.  Cognitive costs of indoor living include impairment of attention, decreased academic performance in the young and a greater cognitive decline in the elderly.

Dr. Walsh did report that natural settings reduce stress and depression, but the amount of time spent outdoors to secure this benefit was lacking.  Most of the studies he examined appeared to focus on poets and philosophers, such that scientific rigor was minimal.  In a normal population, natural settings may enhance cognition, attention, and subjective well-being.


Satisfying relationships account for success in psychotherapy more than the school of therapy that is utilized.  Good relationships are associated with happiness, resilience, and cognitive capacity.  The health risks of social isolation are believed to be comparable to risks of high blood pressure, smoking and obesity.

Similar to the section on “Nature,” Dr. Walsh’s analysis of the literature did not include any guidelines for what defines a satisfying relationship, how many are sufficient, and the frequency which one must engage in good relationships to be therapeutic.


This ancient practice ameliorates a wide array of stress-related psychological and psychosomatic disorders.  Mediation has received much more attention from researchers than yoga, and its benefits may overlap with other strategies to induce muscular relaxation.

It is clear that meditation is beneficial for normal populations, as well as multiple clinical samples.  Dr. Walsh noted that it is less clear how meditation practices compare with each other, or with other therapies; such as relaxation, yoga and self-hypnosis.


Spiritual involvement appears to be most beneficial when it centers on themes of love and forgiveness.  Themes of guilt and punishment are less likely to be helpful to one’s mental health.  Those who attend religious services at least weekly live about seven years longer than those who do not attend.

Those who experience a rich spiritual life have reduced rates of mental disorders; such as anxiety, depression, substance abuse and suicide.  The only significant link between spirituality and physical health is a reduced incidence of hypertension.

ClipartService1Service to Others

Dr. Walsh discussed the so-called paradox of happiness, which means that spending one’s time on others can make one happier.  A major exception to this category is caretaker burnout.  When family members take care of a demented spouse or parent, the sense of internal pressure and obligation may negate the positive affects of contributing to others.

There is considerable research to link selfless behavior (altruism) with psychological, physical and social well-being.  Providing social support may be more beneficial than receiving the help.

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