Can Going Outside Benefit My Mental Health? with Dr. Erin Engle

Faith: Welcome to Health Matters, your weekly dose of health and wellness from NewYork-Presbyterian. I’m Faith Salie.

In honor of Earth Day, we are taking a moment to appreciate nature — and recognize how simply being outside can boost our mental health. Joining me this week to explain how fresh air and sunshine are scientifically proven to be good for our mood  is Doctor Erin Engle, a psychologist at NewYork-Presbyterian and Columbia.

 We discuss the many health benefits of getting outdoors, whether it’s a brief walk around the block, playing outside with your kids, or volunteering at a local community garden.

Faith: Dr. Erin Engle, welcome to the show.

Dr. Engle: Thank you so much, Faith. It’s a pleasure to be here.

Faith: In honor of Earth Day, we are here to talk about nature and specifically why it’s so important for our bodies and our minds to get out into nature. So, Dr. Engle, why is spending time outdoors so important for our mental health? Let’s start there.

Dr. Engle: Well, I think it’s been commonly understood for some time that getting outdoors is good for us. It’s the kind of advice that we receive from teachers or our parents, and it turns out that there’s good scientific reasoning behind this. I mean, certainly having a relationship with nature is good for our mental health.

I think anyone who’s been outside on their lunch break, can attest to its importance for changing up mood, for being able to reduce stress, help with coping, and it’s certainly really helpful when it comes to thinking about key aspects of emotional health, psychological health, and of course physical health, especially when being outside includes activity.

Faith: How do we define nature in this context?

Dr. Engle: When we consider nature and what it is, most of us think about the outdoors, the ocean, rivers, mountains, going for a hike. But importantly, there’s such thing as green space and green space can include anything such as a green plants, grass, what we typically have in our gardens. But thinking about it more broadly, there’s been a movement recently to include and to conceptualize nature as including the little things, especially for those of us who live in the city, having a tree lined street, for example, um, having access to a community garden and to a local park, even how we equip or make our homes comfortable in thinking about including plants or plant life or window boxes or things that give us access to nature, even when we can’t be outside.

Faith: You’re right, when you live in a city, it really makes a difference. You notice it when you’re walking down a street or an avenue that has just simply more trees, or more little flower beds than another neighborhood. It makes such a huge difference.

Dr. Engle: Absolutely.

Faith: Do we get as much of a mental health and physical benefit walking along a city street with traffic and sidewalks and storefronts as we would if we were walking in the woods or in a park in a city?

Dr. Engle: Research suggests that it’s our connectedness to nature that really counts. So if we want to think about it in terms of quality over quantity, that turns out to be pretty important. But because each of our relationship with nature is subjective, meaning we have our own experiences of it in terms of our thinking, our mood, how we feel, what we see. But what it actually turns out to be is that we can enhance our connection to nature simply by being purposeful about that, by looking for opportunities to bring in nature, we can go outdoors and create, I think, a sense of immersion where maybe otherwise we’re surrounded by the city and some of the noise and forms of distraction, which can ultimately be stressful. So I think the short of it is being intentional and bringing a sense of quality to our experience in nature is really what counts.

Faith: It’s springtime and I took a walk in Central Park two days ago and it, it feels quite easy to notice the audacious blossoms everywhere. I’ve heard of something called AWE walks, A W E, which can involve setting your consciousness even on the smallest thing. Like you see a butterfly or you see a squirrel doing something hilarious and squirrely or just a beautiful flower. Kids are great at this, right? But is that part of what it means to have a purposeful experience in nature? 

Dr. Engle: That’s exactly right. I’m talking often with folks about bringing awareness, full awareness, right? Which often involves our senses into the experience of every day. For example, walking mindfully, walking with awareness. And I think bringing together these two benefits, right, of both movement and beautiful surroundings.

We can make good time or we can make time good. And I think the piece that you’re referencing, Faith, is around appreciating via the senses—whether it’s vision and appreciating the beauty that exists inherently in nature, or whether it’s something like stopping to smell the flowers—I’m just reminded that as you mentioned, some of the blossoms coming up, that even something like, the tourism that happens, there’s a reason why there’s so much travel to DC in April, if one is lucky, to appreciate the cherry blossoms and the blooms.

And so bringing in, I think, our sense of appreciation of beauty and also making a walk meaningful. Appreciating the complexity of nature is also to experience it in a more present way.

Faith: And let’s not forget the sense of sound. There are times when I am running around Central Park and I’m listening to a podcast and I think, You know what? Like, the birds are waking up right now. Maybe I should just quiet down and listen to my breathing and listen to the birds.

Dr. Engle: The sounds in the morning are spectacular. And to start a day like that, taking in the beauty of something that’s so organic, is a different way to start the day. And it does bring a sense of positive mood.

Faith: How does the noise, both the, the literal and figurative noise of everyday life, especially in a city, affect our mental health?

Dr. Engle: Often our attention is being competed for, and when we have extraneous factors or natural kind of parts of city life that tend to be distractions, they can also elicit a stress response, meaning more cortisol. In other words, our bodies are preparing in some way to deal with an anticipated threat. When we think about the reverse, choosing to escape or create some relationship, some connectedness with nature that can be something as simple as a community garden or appreciating the tulips on the sidewalk. There is a more calming, uh, effect of, of taking in not only the beauty of those things as it relates to wellbeing, but also thinking about our mood.

There’s some research to suggest that when we are calm, there’s oxytocin released. It’s considered the love hormone, meaning that it’s affiliative. There’s something soothing about that. And I think just by definition, that kind of positive emotion that’s engendered by beauty, and of course using the senses to be present, all of those things collectively will support stress reduction and more enjoyment and quality of living and experiencing.

Faith: Does it sometimes surprise your patients when you’re like, here’s my prescription: Go take a walk in nature.

Dr. Engle: Yes, it’s sometimes hard to get out or to create or cultivate time in that way. And yet I think what we find is many of my, my patients, when we do ourselves a service and try to create more opportunity to connect with nature, we automatically feel differently and that’s interesting because in terms of mental health usually when we action an intention or create movement towards it especially when it’s a value such as beauty or if we think about calm or inviting in, again, nature or learning and have curiosity about that, it naturally extends to mental health.

And I think that when people try it, and I certainly am one who practices what I preach. Uh, so when we, when we actually do that, we wind up feeling better. And it really helps with mood, especially when it’s combined with movement.

Faith: It really does. How often is optimal for spending time in nature?

Dr. Engle: Our abilities to access nature vary, but when we think about sort of getting the most bang for our buck, what’s really going to support mood-related change. I’ve read some research that suggests something like two hours per week although I think the real takeaway message here is that it is about quality. Quality of experience.

And that is a function of connectedness. And just like we have a relationship with people, which brings us closer to our community and has its own mental health benefits, when we develop a relationship or a connectedness with nature, we’re able to experience more positive emotions like happiness, joy, feeling inspired by what we see.

And so I guess what I would say is just like with exercise, right, each individual will have their own subjective experience. Experience of what is the right amount of nature to, to have exposure to, but especially during times of high stress, when we think about work, family life, career, all the other things that we’re often managing, being able to offset that in nature with good quality time is important.

Faith: What are some specific tips you have for getting out in nature and how to build this into a daily or weekly routine? 

Dr. Engle: So I think with any good planning, thinking ahead. I notice even with my calendar, if I don’t write something in, it may not happen. And so, just like we have important work meetings or different family commitments that we make sure to jot down, something that I would suggest people  do is to think in advance.

When there’s a nice day coming or we’re aware that maybe there’s some free time on a particular week, to think about what resources are near them, how they might wish to connect with nature. And thinking about access, it doesn’t have to be something that’s expensive. It might be about creating the time and opportunity to sit and play, you know, with your child on a park bench or explore different pathways in a local park. So this doesn’t have to be something that’s, that’s costly or that involves lift tickets that just may not be accessible to most people. And in fact, there’s something really special about the simplicity that nature provides.

It reduces distraction. And that in and of itself is usually something that tends to be soothing and give us a sense of peace or tranquility.

Faith: Can you talk a little bit more about the physical benefits? What goes on in our body when we get outside in nature?

Dr. Engle: When we think about exposure to sun, for example, we know that certain vitamins in particular are helpful for mood, especially when it comes to these bleak sort of winter months. To be out in nature is to be intentional about our access to sunlight, and something like vitamin D, for example, it helps our bodies. It’s something that’s inherently nourishing, and it just feels good. I think as well, when we’re out in nature, thinking about the benefits of fresh air, especially if that’s combined with movement, chances are we’re going to sleep better that night as a function of spending good quality time outdoors.

Faith: In today’s world, which is just full of relentless technology and constant distractions coming at us, how important do you think it is to experience our time in nature without devices or limiting our devices as much as possible?

Dr. Engle: Oh, I think it’s essential. I think what I’m finding in practice is that simplicity, there’s something about distilling down distractions, especially when some of those distractions may involve content that is distressing. And for any of us looking at the news right now, for some, first thing in the morning, there’s very little reprieve from what can be some content that can promote more stress. 

And in some cases, even thinking about visual images, it’s sort of a secondary trauma impact. So going back to basics, getting out in nature is something that’s soothing. It helps promote good health. Uh, I think we can also, depending on our age and, uh, you know, what sort of comes naturally to us in terms of leisure and enjoyment, we can look for opportunities to support being outdoors, thinking about creative ways to blend art and nature through photography, for example.

Also there’s just a host of free or low cost, no cost programming for, for young children to expose and support their learning about nature and developing a curiosity around the outdoors. Especially when there hasn’t been much access, right? We all can learn a bit about nature, animals, the relationship between different ecosystems. So it winds up being a wonderful way for people of all ages to get outside.

Faith: The things you were listing also called to mind birding together, community gardens, there are a lot of mushroom foraging clubs or just going out and looking for mushrooms. I mean, once you start listing things, you realize the possibilities are almost endless.

Dr. Engle: Absolutely. There’s something for everyone. So certainly I think combining efforts towards education just inherently supports advocacy and better policymaking to protect and preserve this natural resource that we have in nature.

Faith: Which activities do you recommend to someone who might be hesitant to spend more time outdoors?

Dr. Engle: Starting simple with any behavioral change is probably the way to go. Just getting outdoors, period, can be useful. We all—again, implicitly—know, but the research also supports that loneliness and isolation, these are issues, especially for folks living in urban communities. So being able to get outside, start small, put your sneakers by the door. Start with a 10 minute walk to see what it’s like. To see what, what brings joy. To experience how one feels before they went out in nature and then maybe rate mood or just do an informal self assessment to check in with how you feel afterwards. Chances are someone is going to feel better or at least have a different experience than what they had prior.

Faith: Research has shown, I believe, that spending time in nature can improve flashes of creativity, right? And inspiration and, and other reasoning skills.

Dr. Engle: Absolutely. And when we think about anxiety and depression, mood disorders, that usually there’s a certain tension, discomfort and experience of losing energy in some ways, and sometimes rigidity of thought, right? That stands to detract from someone’s quality of life, from experiencing the world around them as fully as they would like.

And so thinking about these benefits, it just so happens that when we’re in nature, something does get freed up, our thought process shifts. We have a different perspective on the world and some might think that that’s a function of again the calming aspects or or joy or the curiosity that nature is bound to spark but it’s encouraging to think that when we’re in a rut of sorts that perhaps forest bathing or just appreciating a nice sunset, right, has the potential to shift even ever so briefly our experience of mood and being in the world.

Faith: Well, Dr. Engle, you are a breath of fresh air. This was a delightful conversation and I’m so grateful to talk with you today.

Dr. Engle: Thank you so much, Faith. This has been a fabulous opportunity. I really appreciate the time. Thank you for having me.

Faith: Happy Earth Day.

Dr. Engle: Happy Earth Day.

Faith: Our many thanks to Dr. Erin Engle

I’m Faith Salie.

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