Mental Health Cheat Sheet

The full physiological and behavioural toolkit for your mind: dosed, mechanism-anchored, and rated by how strong the evidence is, including the promising-but-unsettled. Tools to amplify your agency, not a replacement for care you may also need.

The premise, argued throughout, is that you are not a broken machine waiting to be fixed by an expert, but a system whose inputs you can largely control, and that a large, well-evidenced, and badly underused set of physiological and behavioural levers shapes how you feel. The standard model has too often handed people a diagnosis, a prescription, and a waitlist, and called it care. This is the other half: the things you can do, starting today, to change the conditions your mind is running in.

This amplifies rather than replaces. If you are on medication or in therapy and it is helping, this works alongside it (mind the interactions flagged below), and nothing here is a reason to stop a prescribed treatment. The aim is to widen the set of tools in your hands so that fewer people reach the point of crisis, and those who do have more to work with, so as not to leave anyone to rescue themselves from a genuine emergency alone. Second, because mental ill-health drains the very motivation needed to act, the tools are ordered and tagged for leverage and ease: start with the foundations, add the targeted tools, and treat the frontier as optional experiments.

How the evidence tags work, since this cheat sheet deliberately includes the unsettled, as you’d want from a complete map:

• [Foundational]: strong evidence, large effects, low risk; do these first.
• [Solid]: good evidence for a real, useful effect.
• [Promising]: encouraging but incomplete evidence; reasonable to try, hold loosely.
• [Frontier]: early, experimental, or mechanistically plausible but unproven; included because the map should be complete, flagged so you know what you are trying.
• ⚠ Safety: a specific risk or interaction to respect.

I. Read This First

A few situations where this sheet is not the answer and self-direction is the wrong tool. These are not deference; they are the points where the system that does the deciding is itself compromised, and stabilising first is what gives you back the agency everything else depends on.

• If you cannot keep yourself safe, stop here: The work on this page is for after you are safe, not instead of it. Get through the next hours with another human, a trusted person, a doctor, or a crisis line in your own country. Surviving the crisis is the thing that protects everything else.
• Active psychosis, mania, or a break from reality are not states to self-manage with breathwork and walks. Get skilled help; stabilise first.
• Severe or complex trauma needs a skilled guide, not solo exposure, because unguided re-exposure can re-injure rather than heal.
• Do not stop psychiatric medication abruptly or alone: Whatever you decide about it, the stopping is the dangerous part; do it with medical guidance or not yet.

If none of these apply, you are the operator of a system with many inputs, most of them in your hands. The rest of this page is how to work them.

Step 1: Read the State You Are In

Distress is not one thing. Almost all of it is your threat-and-energy system in one of three modes, and the mode tells you what to do. Find yours.

• Shut down (conservation mode): flat, heavy, exhausted, nothing is interesting, effort feels impossible, you have withdrawn. This is the depressive end, the system conserving because it has read the situation as hopeless. → Worked fully in Pain and Addiction.
• Switched on (arousal mode): wired, anxious, scanning for threat, can’t settle, can’t sleep, mind racing or looping. This is the anxiety end, the alarm that will not stand down. → Worked fully in Fear and Hypervigilance.
• Seeking relief (escape mode): reaching for the thing that briefly switches the state off, the drink, the scroll, the substance, the behaviour, and finding the relief shrinking while the pull grows. This is the addiction loop, relief-seeking from the pain of the other two. → Worked fully in Pain and Addiction.

Most people in a bad patch are in more than one at once, and the three feed each other: the shutdown drives the seeking, the seeking wrecks the sleep, the sleeplessness deepens the shutdown. You do not have to fix all three. Weaken any one and the others lose support.

And if the pattern is lifelong rather than a bad patch, a brain that has always worked differently rather than a system knocked out of range, that is a different thing, addressed in Neurodivergence, and most of the foundations below still apply to the distress that travels with it.

Step 2: Two Questions Before You Act

These are the master tools, because they decide whether you work on yourself or on your situation.

• Which door did I come in? These states are reached through many entrances, an inflammatory or exhausted body, a circumstance of defeat or entrapment, a loss of meaning, a trauma, or chronic sleeplessness. The entrance points to the lever. Ask honestly what was happening when this started, because the depression that came with burnout and no sleep needs different first moves from the one that came with a trapping job or grief.
• Is this internal or external? Sometimes the feeling is a misfiring alarm in conditions that are genuinely fine, and the work is to regulate yourself. Sometimes it is an accurate signal that something is genuinely wrong, a real trap, a real loss, a situation built against your needs, and the work is to change the situation, not to tolerate the intolerable better. You tell which by acting: address the conditions the feeling points at and watch whether it lifts (it was internal) or persists unchanged (it was real). Both answers are useful. The trap is assuming in advance that the problem is always you.

II. The Foundations

These five do most of the work, and almost everything in the later tiers works better on top of them. If you do nothing else, do these.

Movement [Foundational]

A daily walk is the floor, ideally outdoors and ideally in the morning so it doubles as your light. Movement has some of the strongest evidence of any single intervention for depression and anxiety; it drives the same brain-repair processes antidepressants slowly reach for, lowers inflammation, and discharges mobilised stress. Intensity matters less than that it happens.

• Aerobic: ~150 min/week of moderate activity, or 75 of vigorous; even a single brisk walk lifts mood acutely. Zone 2 (conversational pace) builds the base.
• Resistance training: 2-3 sessions/week has its own antidepressant and anti-anxiety evidence, independent of cardio.
• The dose that beats none is “any.” For the depressed, the first rule is to act before motivation returns; start absurdly small (a five-minute walk) and let it compound. See Movement.

Sleep and Circadian Rhythm [Foundational]

Protect a regular wake time above all else, the same time every day anchors the whole clock; the bedtime can drift, the wake time should not. Cut caffeine after about midday (it has a long tail and quietly wrecks the deep sleep you won’t remember losing) and get the screens dim and away before bed. If you cannot sleep, do not lie in bed fighting for it, the fighting is the problem (see arousal-mode tools below).

• Anchor the clock: consistent wake time (even at weekends), morning daylight within an hour of waking (outdoors beats any indoor light), dim and screen-light-reduced evenings.
• For insomnia specifically, CBT-I is the first-line, gold-standard treatment [Foundational], stronger and more durable than sleeping pills, built on stimulus control (bed for sleep only; if awake 20+ min, get up) and sleep restriction (temporarily compress time in bed to rebuild sleep pressure). App-based versions work.
• ⚠ Treat sleeping pills (Z-drugs, benzodiazepines) as short-term only; they carry tolerance and dependence and do not fix the cause. See Sleep & Circadian Rhythm.

Light [Foundational for seasonal, Solid for non-seasonal]

Get bright light into your eyes within an hour of waking (outdoors beats any indoor light, even on an overcast day), and dim and warm your light after sunset. This is the single strongest signal that sets the body clock that governs sleep, mood, and energy. Bright morning light has direct antidepressant evidence, not only for seasonal low mood.

• Morning sunlight: 10-30 min of outdoor light early sets the circadian clock and supports serotonin and mood.
• Bright light therapy: a 10,000-lux lightbox for ~20-30 min each morning is well-established for seasonal depression and, on recent meta-analytic evidence, an effective adjunct for non-seasonal depression too. Cheap, fast-acting, low-risk. ⚠ Can trigger mania in bipolar disorder; use with medical guidance there.

Nutrition and the Gut [Foundational]

Aim the diet at lowering inflammation, more whole and unprocessed food, more plants and fibre and oily fish, less ultra-processed product, because a meaningful share of depression runs partly through an inflammatory pathway and diet reaches mood directly through the gut. Dietary improvement alone has measurably lifted depression in trials. You do not need a perfect protocol; you need fewer ultra-processed inputs.

• The pattern that helps: whole foods, high protein from clean meat sources, plenty of plants and fibre, oily fish, olive oil, fermented foods; minimise ultra-processed food, which feeds inflammation and the craving loop.
• Stabilise blood glucose (protein and fibre, fewer refined-carb spikes) to flatten the mood and energy swings that mimic anxiety.
• Feed the microbiome (fibre, fermented foods); the gut-brain axis is a real route to mood. See Nutrition and Gut Health.
• ⚠ If you have any history of disordered eating, apply dietary tools loosely and with support; rigid rules and numbers can do more harm than good here.

Connection and Purpose [Foundational]

Among the heaviest inputs of all, and the easiest to neglect when struggling. Social isolation carries a mortality risk comparable to smoking; loneliness and meaninglessness deepen nearly every condition. Make one piece of real, in-person or at least voice-to-voice contact a day, however small. Isolation is read by the body as a physiological threat carrying a mortality risk on the order of heavy smoking, and screen-mediated contact does not fully substitute. One conversation counts.

• Connection: regular in-person contact, even small doses; reduce the screen-mediated substitute that displaces it. Recovery needs people, not just protocols.
• Purpose: goal-directed, meaningful activity (work, craft, care, service) is a structural antidepressant. See Connection and Purpose.

III. Targeted Physiological Tools

For arousal/anxiety (switched on):

• Physiological sigh: two inhales through the nose (a second, sharper top-up inhale on top of the first) followed by a long, slow exhale through the mouth. Repeat one to three times for an immediate drop in acute arousal; a few minutes of it daily has measurable mood and stress benefit. This is the fastest voluntary brake on the system there is.
• Extended-exhale breathing: make the out-breath longer than the in-breath (for example in for four, out for six to eight) for a few minutes; the long exhale is what engages the calming branch of the nervous system.
• Exposure, not reassurance, for a specific fear: the threat circuit does not learn from being argued with or reassured, it learns from experience. Approach the feared thing gradually and deliberately, without the safety behaviours and without seeking reassurance, and let the anxiety rise and fall on its own until the system learns it was safe. Reassurance and avoidance feel like relief and are what keep the fear alive. (Full method in Fear and Hypervigilance.)

For conservation/depression (shut down):

• Behavioural activation: action comes before motivation, not after. Do the small thing without waiting to feel like it, because the feeling follows the behaviour in this state and almost never leads it. Schedule one small, concrete, slightly engaging activity and do it regardless of mood.
• Morning light + morning movement together: the highest-leverage combination for the shut-down state, hitting the body clock and the brain-repair pathways at once.
• Read the door and the situation (Step 2) hardest here, because shutdown is often a response to a real entrapment or loss the symptom is pointing at.

For insomnia:

• Stop trying to sleep, because trying is arousal and arousal is what blocks sleep. Get out of bed if you are not sleeping so the bed stops being a place of wakeful frustration; do not chase lost sleep by spending longer in bed, which dilutes it; and lower the stakes, because the fear of a bad night causes the bad night, and an occasional bad night is genuinely harmless. The structured version of this, CBT-I, is the first-line treatment and beats sleeping pills for chronic insomnia. (Mechanics in Sleep & Circadian Rhythm.)

For the escape loop/addiction:

• Manage the cue and the context, not the willpower: the craving is fired by exposure and cues, so change the environment to fire it less rather than trying to out-resist it in the moment, which pits depleted control against a sensitised pull and loses.
• Treat what the escape is for: ask what the substance or behaviour is doing for you, what pain or state it relieves, and put a non-destructive way of meeting that need in its place, because removing the relief without addressing the need just leaves the pain exposed.
• Restore the foundations, because sleep and stress-recovery rebuild the very impulse-control capacity that depletion strips away.

IV. Nutrients and Supplements

None is a foundation; several have genuine evidence, and the interaction flags matter, especially if you take any psychiatric medication. ⚠ A blanket rule: if you are on an antidepressant or other psychiatric drug, check every supplement below with a doctor or pharmacist before combining; several raise serotonin and can interact dangerously.

Correct deficiencies first [Solid]

Deficiency in any of these can directly cause low mood, anxiety, fatigue, or brain fog; correcting a real deficiency is high-value, supplementing beyond sufficiency usually is not. Worth testing or addressing:

• Vitamin D (common deficiency, linked to depression; supplement if low).
• B12 and folate/methylfolate (deficiency causes mood and cognitive symptoms; relevant to the methylation discussions elsewhere in the section).
• Iron/ferritin (low iron causes fatigue, low mood, and restless legs; especially in menstruating people).
• Magnesium (involved in stress and sleep; glycinate or threonate forms; ~200-400mg; reasonable evidence for anxiety and sleep, low risk).
• Zinc and omega-3 index round these out.

Omega-3 fatty acids [Solid]

EPA-predominant fish oil (~1-2g EPA daily) has meta-analytic support for depression and can augment antidepressants, likely via lowering brain inflammation. ⚠ High doses thin the blood, caution with anticoagulants.

The better-evidenced botanicals [Solid to Promising]

• Saffron (~30mg/day): reasonable trial evidence for depression and anxiety, comparable to low-dose antidepressants in some studies. ⚠ Stay under ~1g/day.
• St John’s Wort (Hypericum): genuinely effective for mild-to-moderate depression, on par with some antidepressants. ⚠ The big one: it is a potent CYP3A4 inducer that weakens many drugs (oral contraceptives, anticoagulants, immunosuppressants, some psychiatric and cancer drugs) and, combined with SSRIs or other serotonergic drugs, can cause serotonin syndrome. Do not combine with other antidepressants, and check it against everything you take.
• L-theanine (~200mg): calms without sedating; useful for acute anxiety and alongside caffeine; low risk.
• Ashwagandha (standardised extract, short-term): promising for stress, anxiety, and cortisol. ⚠ Additive sedation with benzodiazepines, can alter thyroid hormone, possible serotonin interaction with antidepressants, and emerging reports of rare liver injury; short-term use, caution in thyroid conditions.
• Rhodiola: modest evidence for stress-related fatigue; generally well-tolerated.

Targeted compounds [Promising to Frontier]

• Creatine (~5g/day): emerging evidence it may augment antidepressants, possibly more in women, via brain energy metabolism. ⚠ Can worsen mania in bipolar.
• NAC (N-acetylcysteine) (~1200-2400mg/day): promising for OCD, trichotillomania/skin-picking, and as an addiction adjunct, via glutamate and antioxidant pathways. Slow to act (weeks to months).
• Inositol (~12-18g/day): some evidence for panic and OCD; mixed overall.
• Probiotics / “psychobiotics” [Frontier]: specific strains show early promise for mood and anxiety via the gut-brain axis; evidence is preliminary.
• ⚠ Serotonin-precursor caution: 5-HTP, L-tryptophan, and SAMe can each help mood but must not be combined with SSRIs/SNRIs or other serotonergic agents (serotonin syndrome risk). SAMe can also trigger mania in bipolar.
• ⚠ Avoid the genuinely risky frontier: compounds like methylene blue (a potent MAO inhibitor, dangerous serotonin interactions) and “microdose lithium” supplements are sometimes promoted; the risks and interactions are real and the evidence thin. Not without medical oversight.

V. Psychological and Behavioural Tools (Self-Administrable)

These are not pharmacological, but they are physiological in effect, retraining the circuits the conditions run on, and you can largely do them yourself or with a book or app.

• Behavioural activation [Foundational]: for depression, schedule and do small, meaningful or rewarding activities before the desire returns; acting first reopens the reward circuits depression walls off. One of the best-evidenced therapies, and self-directable.
• Graded exposure [Foundational]: for anxiety, panic, and phobia, face the feared thing in steps (a 0-100 ladder), staying with each until the alarm drops, building new safety learning over the old fear. Avoidance feeds anxiety; graded approach dissolves it. See Fear and Hypervigilance.
• Cognitive work/CBT [Foundational]: identify and test the catastrophic or self-attacking thoughts, and rebuild more accurate ones; strengthens the prefrontal brake over the threat and mood circuits. Self-help CBT books and apps have real evidence. Tie to Mental Models.
• Mindfulness meditation [Solid]: regular practice (and structured programmes like MBCT) reduces anxiety and protects against depression relapse; ~10-20 min/day. See Mindfulness.
• Expressive/gratitude writing [Promising]: writing about difficult experiences (Pennebaker-style) and regular gratitude practice both have reasonable evidence for mood and stress, low-cost adjuncts, not headline acts.
• Self-distancing: viewing your situation from the outside (“third-person”) reduces rumination and emotional reactivity.

VI. The Frontier

Included because you asked for the complete map, and because some of this is where the field is genuinely moving, but flagged clearly: these are emerging, often clinical-only, and not established self-care.

• Ketamine/esketamine [Promising, clinical]: rapidly boosts neuroplasticity and can lift treatment-resistant depression within hours; FDA-approved (esketamine) for that use. Administered medically; effects are often short-lived; not a DIY tool.
• Psilocybin and other psychedelics [Frontier, clinical-trial]: striking trial results for depression and addiction, but not approved, and ⚠ MDMA-assisted therapy was rejected by the FDA in 2024 over safety and trial-design concerns. Set and setting and screening matter enormously; self-experimentation carries real psychological risk, especially with any psychosis or bipolar vulnerability.
• Ketogenic/metabolic psychiatry [Frontier]: a ketogenic diet is under serious investigation for bipolar and other serious mental illness via brain energy metabolism; early case series and small trials are encouraging, controlled evidence is still thin. Best pursued, if at all, with clinical support, especially in bipolar.
• Transcranial stimulation [Promising to Frontier]: TMS is an established clinical treatment for treatment-resistant depression (in-clinic, not DIY); tDCS devices are sold to consumers but the evidence is mixed and ⚠ DIY montages carry burn and dosing risks.
• Non-invasive vagus nerve stimulation, HRV biofeedback, floatation-REST [Frontier]: each has early, plausible evidence for anxiety and stress; reasonable low-risk experiments, not proven treatments.

VII. How to Use This

Because the conditions themselves sap motivation, do not try to do everything. The sequence that works:

1. Stabilise the foundations first: sleep, movement, light, food, one human connection. These are 80% of the available return and make everything else work.
2. Add one or two targeted tools that fit your pattern: breathwork and exposure for anxiety; behavioural activation, light, and morning movement for depression; CBT-I for insomnia; the reset and rewarding-alternatives for addiction.
3. Correct any real deficiencies, and add a well-evidenced supplement or two if useful, respecting the interaction flags.
4. Treat the frontier as optional experiments, one at a time, so you can tell what does what, never as a substitute for the foundations or for help you genuinely need.
5. Start absurdly small. One walk. One physiological sigh. One earlier bedtime. The point is momentum, not perfection. The system changes through repeated small inputs, which is exactly what is doable even on the worst days.

You are the operator of a system with many inputs, most of them in your hands. Use professional help and medication as tools when you need them, hold the few red lines that keep this safe, and otherwise work the levers, patiently and in your own favour.

VIII. Cross-Links

• Mental Health for the section overview
• Why Do I Feel Like This?, Fear and Hypervigilance, Pain and Addiction, and Neurodivergence for the conditions these tools address
• Mental Health Resources for the sources