In 2020, the year Amanda lost her mother, husband, job and pre-pandemic normalcy, she was diagnosed with major depressive disorder. “My life was just spiraling down and down and down,” she says.
To help with her symptoms, in addition to an antidepressant prescription, Amanda was given a “social prescription”: a referral to a non-medical, community-based activity, typically involving movement, nature, art or service. Amanda lives near Devon, England, and became curious about sea swimming after reading about its health benefits and watching other women do it at her local beach all year round. When she told this to her mental health nurse, she was prescribed a spot in Chill Therapy, an eight-week course that teaches swimming, floating and breathing techniques to build skill and confidence navigating the open water.
Six years later, Amanda turns to swimming in the sea whenever she feels stressed. “It invigorates me and makes me feel I can cope with anything,” she says. “I can’t do without it, to be honest.” She is now down to the lowest dose of her antidepressant, and has made a ton of friends along the way: “I feel refreshed in body and soul.”
Though research has long linked hobbies involving exercise, arts and nature to a wide range of health benefits, social prescribing now lets people like Amanda participate in them as part of their healthcare, typically covering barriers like cost and transportation. While the practice is more common in the UK, some insurers in the US are starting to participate in social prescribing.
But you don’t need a doctor’s note to get started. We asked experts in the social prescribing field for tips on picking a hobby that will actually improve your health.
Match your symptom to the science
When choosing a hobby, think about how you’re feeling now, and how you’d like to feel in the future.
For instance, if you’ve been feeling tired or down, like Amanda, science suggests you should move your body; for example, multiple studies show sea swimming can help reduce depression and depressive symptoms.
On a physiological level, this makes sense: aerobic exercise has been linked with gains in mood-boosting endorphins and serotonin. Additionally, time spent in nature is linked with lower levels of cortisol, a stress hormone.
Feeling distracted? Nature is also good at improving focus. According to the Attention Restoration Theory, nature is uniquely equipped to restore our depleted mental resources by providing “soft fascination”, a state of effortless focus that captures our attention without draining it. This could explain why nature has been shown to improve our executive functioning and concentration.
Creative activities can help with getting through sadness, isolation or pain. “Art is a human experience – it helps folks get out of their loneliness and into a flow state, which can rewire their brain from trauma,” says Holly Jacobson, CEO of Path With Art, a Seattle-based non-profit that offers free arts-based community programming. A new small study found that Path with Art participants experienced statistically significant gains in mental wellbeing and efficacy, and reductions in loneliness. Earlier small studies found that painting can reduce anxiety, and that art-making can reduce cortisol levels after 45 minutes.
Ask yourself what matters to you
Some people can’t see themselves knitting, while others might rule out sports because of injury. Research suggests we are more likely to follow through on an activity if we have intrinsic motivation – the internal drive to do something because we find it genuinely enjoyable or satisfying, rather than an external reward, like losing weight.
That’s what worked for Amanda. Instead of receiving a finger-wagging recommendation to exercise, she says she was intrinsically motivated to go sea swimming. “When I could not go in the sea while waiting for hip replacement for two years, I used to picture myself in the waves with my friends and it always cheered me up,” she says.
To help uncover a patient’s intrinsic motivation, professionals called link workers are tasked with listening to patients and helping them uncover their unique curiosities. Many are trained in motivational interviewing, an evidence-based, person-centered conversational technique that helps people work within their own value system and reasons for change, says Dr Tim Anstiss, a medical doctor who helped to develop the training, which recommends questions like: how might your life change if you joined that group? Who or what gives your life meaning and purpose?
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Doing what gives us purpose and meaning is “vital” to our health and wellbeing, agrees Dr Ivory Rose, a California-based occupational therapist and lead within Social Prescribing USA. “Leisure pursuits are a very important part of [our health], but often get forgotten in the face of an illness or busy schedule,” she says, referencing studies that link meaningful activity to greater health.
Rose aims to rebuild this association for clients with questions like: what is something you used to enjoy doing that you haven’t done in a while? What is important to you to be able to do?
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Use mindfulness to identify activities that naturally capture your attention
Mindfulness is “the very simple process of noticing”, says Dr Ellen Langer, a psychology professor at Harvard University. In her most recent book, The Mindful Body, she explores the wide-ranging benefits of being more mindful, which include improving your memory, creativity and energy, and strengthening your social relationships.
Langer says to start by noticing three new things about something familiar – say, a person, place or object. Every time you notice you are on autopilot, you build “a healthy mindset for uncertainty”, she says. This is important because people who are stressed or in pain often “believe the symptoms they have are going to stay the same or get worse”, and that suffering is constant, Langer says. But according to research, people can feel better when they notice improvements and reflect on why they feel better.
Dr Rachel Zoffness, a pain psychologist teaching at Stanford and the University of California at San Francisco, similarly points to research showing that pain can increase or decrease, depending on where we direct our attention.
In her recent book, Tell Me Where It Hurts, she offers tips for pain relief. She says she sometimes asks patients directly: “Will you tell me about a time you were so absorbed in an activity that you briefly forgot about your pain?”
Just say ‘yes’
If you’re not sure what brings you meaning or what captures your attention in adulthood, try reflecting on what brought you joy in childhood. “When we were kids, playing did not relate to a specific goal, but it’s the most natural form of learning,” says Purvi Shah, founder of PlayRx.life, a wellness platform. Shah advises clients to “say ‘yes’ to something new, especially when they are stuck in a rut and problems seem overwhelming”.
Caitlin Marshall, a licensed clinical social worker and co-author of Creative First Aid, agrees. In her work leading creative workshops on activities including beekeeping and watercolor painting, she focuses on helping people who are experiencing psychological distress rediscover a sense of childlike joy. “It’s about learning to help people do what feels good and inspiring to them,” she says.
Encouraging participants to be open-minded helps them to discover new things about themselves. “Some of them will arrive and say: ‘I hate cooking.’ Then those people are the ones that end up loving it,” Marshall says. “It’s hard to be judgmental and curious at the same time.”
