I recently had a period of time where I had booked some time off from my regular activities. I had a huge long list of things that I wanted to do during that time. Do you think I got any of them done?
Nope. I was completely unproductive. I mean really bad. I did not even keep up with the day to day activities.
OK, so I got a lot of rest and relaxation. Do you think I felt refreshed after?
Nope. I felt more lethargic than ever. Hmmm. It is backwards from what you would think. What's going on?
I was beating myself up afterwards, when I came to a realization. This is what Occupational Therapy really is about. Being engaged in meaningful occupations is good for us. It energizes us, and makes us want to do more. Engaging in my everyday activities makes me a more productive and happier person.
The roots of Occupational Therapy were based around this concept. Early OTs realized that soldiers recuperating in military hospitals needed to have meaningful things to do.
When we have too much time to think, our thoughts start to go around and around in our heads, and this can be a really bad thing. I have seen how this works in a negative way for people with serious psychiatric disorders.
Many people I have known who had schizophrenia would have their delusions get worse when they had very little to do. It seemed the thoughts would go around and around and if there were no activities to interrupt them, the delusions would spiral out of control.
I also noticed this with people who had depression and anxiety. If they lacked activities to keep them busy, their thoughts tended to get worse and worse.
If there are no reality checks, I think it is also really easy to become obsessed with thoughts related to yourself, and to stop thinking about others as much. This idea suggests that occupations that involve helping others would be particularly effective. In fact, I have often worked with clients to find volunteer positions.
I did a quick search for articles that studied whether volunteer work promotes well-being, and was really surprised at the lack of information. Some studies do say that people who volunteer have better well-being than those who do not (Thoits & Hewitt, 2001). However, I could not find any randomized control trials, and the studies I found did not convince me about causation. It is possible that people who are more well are more likely to volunteer, not that volunteering makes them more well.
Also, much of the research that is available focuses on older adults. A PubMed search with the words "schizophrenia" and "volunteer" in the title yielded no results.
It seems to me that encouraging people to volunteer might be a powerful tool to help people, yet it does not seem that people are researching it, which is rather disappointing. I guess it would be a lot more difficult to find funding for this kind of research than for a new medication.
As an OT, this is a concern for me. We are promoting engagement in meaningful occupations, but we are not studying whether this is effective. We think it is, and can provide anecdotal examples, but only have sparse, correlational evidence to back it up.
As for myself, I have now learned that I need to work on finding the right level of being busy to allow myself to be my most productive.
Thoits, P.A. & Hewitt, L.N. (2001). Volunteer Work and Well-Being. Journal of Health and Social Behavior, vol. 42(2), p. 115-131.