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What is Wellness?

Larry Fricks, Deputy Director at the Center for Integrated Health Solutions (CIHS), says that this is a vague term that means different things to different people; wellness is not something to take lightly. For many,  it is one of life’s pillars, and has enormous influence on self-directed whole health and quality of life. In the context of behavioral health and primary care integration, CIHS promotes wellness as a personal awareness of creating a healthy lifestyle, understanding its role in mind-body resiliency and disease prevention.

“Resiliency” is a term usually associated with “bouncing back.” However, as science-based resiliency factors become better known, our understanding of its centrality to prevention grows. A key concept in healthcare reform, prevention is essential to people living with addictions and mental illness who can die decades before the rest of the population because of often preventable and untreated chronic illness such as diabetes, obesity, and heart disease aggravated by poor health habits, such as smoking and poor nutrition, and social determinants like poverty.

CIHS built upon existing research and information to develop 10 whole health, wellness, and resiliency domains. These domains are meant to inform patients and primary care and behavioral health providers as they develop treatment goals that address the “whole person” and promote prevention through resiliency. The 10 domains include:

  1. Stress management. Prolonged stress has an undeniable adverse effect on health. It can — and does — lead to illness. It can also precipitate relapse, both in mental illness and in addiction. The ability to reduce and/or counter stress is critical in dealing with behavioral health problems, as well in promoting health and wellness.
  2. Healthy eating. Most people have some idea of what foods are healthy, and understand that eating more calories than you use leads to weight gain. Developing personal eating habits that promote better health is important for everyone, especially people who have, or are at risk for, health problems like diabetes, heart disease, and high blood pressure. In the context of some chronic illnesses, eating healthy becomes vital to prevention and recovery. 
  3. Physical activity. Exercise and other forms of physical activity not only help maintain a healthy weight, but also help improve overall health and behavioral health — and reduce stress, a daunting provocateur of poor health and wellness. 
  4. Restful sleep. Getting adequate sleep is more important than many people realize. Long-term sleep deprivation is associated with many illnesses, including high blood pressure, heart attack, stroke, obesity, and behavioral health problems.
  5. Support network. Human connections — either through ensuring a robust “support network” or providing “service to others” — are integral to health and wellness. People with strong social ties have much lower rates of disease and premature death than those who feel isolated and alone. Living in isolation not only increases cellular wear and tear, but also paves a highway to super stress.
  6. Service to others. “Service to others” and “support network” are two sides of the same coin. We all need connectedness to survive. It’s no surprise that service to others and support networks play a major role in initiating and sustaining recovery.
  7. Optimism based on positive expectations. Personal hope that one’s life can be better encourages happiness and a sense of wellbeing. In fact, research has found that heart patients with optimistic recovery expectations are 30% less likely to die over the next 15 years than less optimistic patients, regardless of disease severity.
  8. Cognitive skills to avoid negative thinking. Whereas “optimism based on positive expectations” is based on attitude toward the future, “cognitive skills to avoid negative thinking” have to do with attitude toward oneself. A person increases their chance at happiness by telling his or her self a more positive story, rather than a miserable one. As Health Consultant and Writer Martha Beck stated, “Your situation may endanger your life and limbs, but only your thoughts can endanger your happiness.”
  9. Spiritual beliefs and practices. Spiritual beliefs are tremendously personal, and spirituality means something different to everyone. For some, spiritual beliefs are clear and concrete, and spiritual practices translate into specific religious rights, rituals, and ceremonies. For others, spiritual beliefs are vague and more mysterious. Regardless, for many, spirituality, meaning, and purpose are inseparable, and spirituality involves seeking meaning and purpose. 
  10. A sense of meaning and purpose. Many people develop a sense of meaning and purpose through spirituality, ultimately converging a person’s beliefs and values. This sense of meaning and purpose helps a person weather life’s storms.

Caregivers — whether primary care, behavioral health, or peer support — are in an ideal position to educate people about wellness and resiliency, and the importance of both in prevention. People with addictions and mental illness must include wellness and resiliency in their overall treatment goals to achieve recovery, better health, longer life, and a greater sense of wellbeing.

For more information on wellness, visit CIHS.

CIHS provides training and technical assistance to the Substance Abuse and Mental Health Services Administration’s Primary and Behavioral Health Care Integration grantees. Each issue of eSolutions profiles a grantee’s work.