Why Psychiatrists Should Be Using Nature to Treat Patients

A new public health trend is spreading rapidly across the globe: doctors have begun writing nature prescriptions for their patients.

One doctor in San Francisco has even taken the initiative to start up a nonprofit organization dedicated solely to fostering awareness and appreciation of the health benefits of nature.

It’s known as ParkRx, and acts as a resource for doctors to write nature prescriptions, aiding them in locating the nearest park to a patient’s home — akin to the way doctors locate the nearest pharmacy.

What’s fascinating about this idea is that it is so simple. Take a quick survey around your workplace, classroom, or local bar — most people will agree that being in nature makes them feel good. With the exception of those affected by seasonal allergies, for whom being out in the great outdoors in the thick of spring can be torturous.

Needless to say, it’s not that complicated. Get outside! It’s good for you. We already know this, right? Well, maybe.

Most people don’t differentiate between outdoor active time (playing organized sports or running outdoors) and outdoor restorative time.

While the former is definitely healthy, as regular exercise is vital to physical health and fitness, there’s a lot to be said for the latter — time spent meandering through a hiking trail in the forest, or meditating on the beach as the waves crash gleefully against the shore.

Or simply sitting outside on a park bench, being mindful of the birds chirping, the leaves on the trees shuddering, or the undulating blades of grass that lie beneath your feet.

Oddly enough, it is often our simplest interactions with nature that yield the most pronounced effects.

While its exact mechanisms are not adequately understood, scientific findings have demonstrated that nature has immense power to impact our wellbeing.

According to a study published in Proceedings of the National Academy of Sciences, experiences within natural environments led to a significant reduction in neural activity within the subgenual prefrontal cortex — a region of the brain involved in rumination, a repetitive negative thought pattern that is common in patients with obsessive-compulsive disorder, generalized anxiety disorder, social phobia, and major depressive disorder.

Rumination involves a prolonged focus on certain negative, often self-deprecating, thoughts or emotions.

It typically precedes an anxious or depressive episode and therefore further exacerbates mental illness. Here lies an unfortunate paradox; that which is the product of anxiety or depression often becomes its creator.

Since nature appears to reduce the occurrence of rumination, the logical interpretation would be that nature can act simultaneously as an antianxiety and antidepressant. Perhaps not to the extent of antidepressant/anxiolytic drugs, but as a supplement — and for those with mild symptoms, maybe even as a treatment on its own.

While the notion that “nature makes us feel good” seems a bit rudimentary and even obvious, the subsequent role that it can play in mental health treatment may not be so evident.

For example, many will scoff at the idea that taking a hike will relieve depression — and it certainly isn’t that simple. But the power of nature to relieve these harmful recurring symptoms that worsen stress, depression, and anxiety cannot be overlooked.

Another study published in the International Journal of Environmental Research and Public Health evaluates the physiological effects of the practice known as “Shinrin-yoku” in Japan — commonly known as nature therapy or forest bathing.

“Despite living in this modern era and surroundings, our bodies are best adapted to living in a natural environment.”

According to the scientists who led the study, humans have spent the majority of their evolutionary existence in natural environments, and understandably so — we are best suited to thrive in nature, not man-made environments such as office buildings.

As they introduce the phenomenon of nature therapy, the authors reference the widespread empirical evidence that supports the notion that “exposure to stimuli from natural sources [such as forests, plants, nature sounds, and natural wood] induces a state of hyperawareness and hyperactivity of the parasympathetic nervous system that renders a person in a state of relaxation.”

In layman’s terms, exposure to nature triggers a neurochemical reaction in the brain that alleviates stress and anxiety, instead making us feel calm and relaxed. Similar to the way in which medication alleviates the “fight-or-flight” psychological response that commonly triggers anxious feelings.

So, I would venture to say that nature could even be used as a medication, which would be especially relevant to those individuals who do not respond well to traditional drugs.

While they are clinically effective, antidepressants have a myriad of unpleasant side effects, including headaches, nausea, diarrhea, confusion, dizziness, decreased libido, inability to orgasm, and fatigue — not everyone’s cup of tea.

Far too often, patients are reluctant to speak up about uncomfortable side effects, either because they’re embarrassed or afraid to forfeit the positive effects of the medication.

Furthermore, medication only alleviates symptoms temporarily. Oftentimes, shortly after a patient tapers off of the drugs, their troublesome symptoms return and mental health declines. Perhaps this occurrence suggests that medication is only a band-aid, rather than a truly effective treatment.

Antidepressants certainly have their place in mental health treatment, but I would like to emphasize that medication is certainly not the only treatment option. Cognitive-behavioral therapy, exposure and response prevention, and interpersonal therapy are all highly effective treatment options for individuals suffering from anxiety disorders, mood disorders, and depression.

Furthermore, preventative medicine is now preferred by many practitioners, conveying the message that we should nip it in the bud rather than merely covering it with a band-aid.

As the conversation around mental health evolves, I implore you to maintain an open mind and give nature a chance. One day, it may become a firstline treatment for mental illness.

Bratman, G. N., Hamilton, J. P., Hahn, K. S., Daily, G. C., & Gross, J. J. (2015). Nature experience reduces rumination and subgenual prefrontal cortex activation. Proceedings of the National Academy of Sciences, 112(28), 8567–8572. Retrieved July 12, 2019, from https://www.pnas.org/

Healthy Parks Healthy People: Bay Area. (2019). Retrieved July 12, 2019, from https://www.parkrx.org/

Song, C., Ikei, H., & Miyazaki, Y. (2016). Physiological Effects of Nature Therapy: A Review of the Research in Japan. International Journal of Environmental Research and Public Health, 13(8), 781. Retrieved July 12, 2019, from https://www.mdpi.com/journal/ijerph