TED Series – Part VIII: The Hidden Conversation: How Nutrition Shapes Emotional States


Daniel Mirea (October 2025)
NeuroAffective-CBT® | https://neuroaffectivecbt.com


Abstract

In this eighth instalment of the TED (Tired–Exercise–Diet) Series, we turn to the neuroscience of food and drink, how what we consume shapes emotional regulation, cognitive performance, and overall mental health. Food is not merely fuel; it is information – biochemical data moving continuously from gut to brain and back again, influencing motivation, focus, mood, and even how we learn and relate.

Introducing TED within the NA-CBT® Framework

Within the NeuroAffective-CBT® framework, TED (Tired, Exercise, Diet) functions as the biologically grounded scaffold of self-regulation that stabilises the Body–Brain–Affect triangle. Here, “D” for Diet is not a list of prohibitions or lifestyle prescriptions. It represents a set of neuro-behavioural levers capable of modulating dopamine, serotonin, immune signalling, circadian rhythm, and the vagus-mediated gut–brain axis, the intricate “wiring loom” that connects body and mind (Mirea, 2023; Mirea, 2025).

Earlier instalments in this series examined the key physiological regulators that underlie emotional and cognitive balance:

Creatine – cellular energy and motivation (Part I)
Insulin Resistance – metabolic flexibility and mood (Part II)
Omega-3 Fatty Acids – neuronal membrane integrity (Part III)
Magnesium – stress buffering and neural inhibition (Part IV)
Vitamin C – antioxidant defence and neurotransmitter synthesis (Part V)
Sleep – the neurobiology of fatigue and recovery within the Tired pillar (Part VI)
Exercise, Sport Science and Movement – strength and resilience (Part VII)

This final chapter focuses on Diet, how nutrition interacts with the emotional brain and how eating can steady the mind, foster neuroplasticity, and restore a coherent dialogue between body and affect. Each meal sends molecular messages, amino acids, fatty acids, micronutrients that speak directly to our emotional circuitry. If sleep restores and movement activates, diet sustains, it provides the biochemical landscape on which both rest and action depend.

Understanding this hidden conversation allows us to view nutrition not as restriction, but as regulation – a way of cultivating emotional steadiness and cognitive vitality through biochemical literacy. Within NeuroAffective-CBT®, such literacy transforms eating from an automatic behaviour into an intentional act of self-alignment.

Important: TED articles complement, not replace, medical advice! Always discuss changes to diet, supplements, or treatment with your GP or qualified health professional.


When Food Became Feeling

The Evolutionary Roots of Emotional Nutrition

The connection between what we eat and how we feel seems obvious at first glance. Food is survival, and the brain, nature’s master regulator of survival, is inevitably obsessed with what we ingest. To keep us alive, it rewards us for consuming what nourishes and warns us against what harms. In that sense, emotions are communication tools: they push or pull us toward or away from things essential to survival. Pleasure tells us to approach; disgust tells us to avoid.

Emotions are central to every moment of our lives, shaping perception, decision, and meaning. Yet despite their importance, few of us truly understand where emotions come from or how deeply they intertwine the brain and body. Emotion is not a phenomenon that happens in the head alone; it is a full-body event, a conversation between neural circuits, hormones, muscles, and sensory organs (Huberman, 2023).

The scientific story of emotion stretches back centuries, from Darwin’s early theories of universal emotional expression to modern neuroscience. Darwin (1872) proposed that emotions evolved as adaptive action programs, biologically embedded to guide behaviour and secure survival. This idea has since found robust confirmation in neuroimaging and behavioural research (Panksepp, 1998).

According to Dr Andrew Huberman, Professor of Neurobiology at Stanford University, the two most robust and universal emotional responses are approach and avoidance. When we encounter something we like for instance, a pleasant smell or taste, the correspondent behaviour is to lean in, inhale, and expand our posture to take in more of it. When we encounter something we dislike, our default behavioural response or instinct is to lean back, turn away, or even hold our breath, a remnant of ancient mechanisms that once protected us from ingesting toxins or inhaling pathogens (Huberman, 2023).

These primitive body movements reflect the underlying logic of emotion itself: a biological push–pull system that regulates approach and aversion. Deep brain structures such as the basal ganglia contain “go” circuits that promote action and “no-go” circuits that inhibit it – mechanisms that operate beneath conscious awareness yet determine much of our emotional behaviour (Mirea, 2023; Huberman, 2023).

From this perspective, emotions are the brain’s predictions about necessary actions in any given moment. They are not arbitrary feelings but dynamic signals that prepare the body to move, toward nourishment or away from threat. Food, therefore, sits precisely at this decision point. Taste, smell, interoception, and posture converge to produce motivation and choice.

Since the dawn of our species, emotion and nourishment have been partners in survival. The infant’s first emotional learning arises through feeding: hunger, relief, pleasure, comfort. Long before we had words, flavour was communication. Even today, every bite still speaks to the nervous system – an unbroken dialogue between physiology and feeling.

In NeuroAffective-CBT®, emotion is described as a body–brain–affect circuit. The body gathers sensory and chemical data; the brain interprets that data into feeling; affect then drives behaviour – approach or avoidance. Food is part of that loop. Each meal is both nutrition and information.

TED Takeaway: We do not just eat to live; we live through what we eat. Food is our first emotional language. Design your environment so that “move-toward” cues lead you to the foods that truly support you. Make the right choice the easy choice!


The Gut: A Second Brain with Its Own Voice

How the Microbiome Speaks the Language of Emotion

Inside your abdomen lives a civilisation of roughly 39 trillion microorganisms, weighing about as much as your brain. Together, they form the gut microbiome, an ecosystem that digests food, manufactures vitamins, regulates immunity, and produces neuroactive chemicals such as serotonin and GABA, both of which directly influence mood, calmness, and emotional tone (Wei et al., 2022; Appleton, 2018).

Astonishingly, about 95% of the body’s serotonin, often called the “happy chemical”, is synthesised not in the brain, but in the gut’s enterochromaffin cells (Wei et al., 2022). When this microbial community thrives, serotonin and GABA levels rise, helping the brain register safety and satisfaction. When inflammation, stress, or poor diet disturb the microbiome, the system tips into imbalance, and emotional symptoms often emerge as irritability, anxiety, or low mood (Appleton, 2018).

This intricate conversation between the gut and the brain travels along the vagus nerve, the body’s longest cranial nerve, connecting the brain to nearly every major organ. It meanders from the brainstem through the chest to the intestines, touching the heart, lungs, and liver along its route. It is, in effect, the biological internet cable linking your internal organs to your emotional life. When the gut releases inflammatory or distress signals, the vagus nerve carries those alarms upward to the brain; when we breathe slowly, hum, sing, or chew mindfully, it transmits calm signals in the opposite direction (Lu et al., 2024).

But this communication is not purely chemical. Within the gut wall lies a network of neuropod cells, remarkable sensory units discovered by Dr Maya Kaelberer and colleagues at Duke University. These cells are equipped with electrical synapses that can detect nutrients such as glucose, amino acids, and fatty acids, and then send rapid signals directly to the brain (within milliseconds), to shape perception, emotion, and appetite (Kaelberer et al., 2018).

This discovery explains why the gut is sometimes referred to as the “second brain.” It does not merely digest; it perceives. The gut continuously samples the external world through food, drink, and bacteria and, informs the brain about what is safe, satisfying, or potentially harmful. It helps explain cravings, aversions, and the emotional resonance of eating. When you enjoy a morning coffee with a biscuit, the gut’s chemical sensors are already communicating with your midbrain reward circuits, producing the pleasurable surge that fuels alertness and comfort.

In NeuroAffective-CBT®, this gut–brain dialogue embodies the biological foundation of interoceptive awareness, also known as, the ability to sense internal bodily states. When we practise mindfulness or direct calm, non-judgemental attention inward, we become more attuned to these subtle signals. Over time, this practice refines emotional regulation by aligning bodily feedback with cognitive understanding (Goldin and Gross, 2010; Mirea, 2024).

From the rectum to the oesophagus, this 9–10 metre canal is not only our largest internal organ but arguably our most socially connected one, continually interpreting the external world through what we ingest and how we feel. As we begin to appreciate this complexity, we can see that mental health is not confined to the brain. It is a networked experience, a dialogue between neurons, microbes, and meaning.

TED Takeaway: When your gut talks, your brain listens. Nourish that conversation!


Good Bacteria, Bad Mood: The Microbiome and Depression

When Emotional Health Depends on Microbial Harmony

The phrase “gut feeling” has never been more literal. In recent years, neuroscience has confirmed what intuition long suspected, that our mental health depends not only on the chemistry of the brain but also on the ecology of the gut. The bacteria, fungi, and viruses that inhabit our intestines do far more than digest food; they influence emotion, immunity, and even identity. When that internal ecosystem becomes imbalanced, mood often follows.

Research has shown that people suffering from depression or chronic anxiety tend to have less diverse gut microbiomes, alongside a higher concentration of bacterial species that produce inflammatory metabolites (Kelly et al., 2016; Foster et al., 2021). These molecules can cross the blood–brain barrier, altering neurotransmitter balance and disrupting neural circuits involved in mood regulation. In a striking series of animal experiments, transferring gut bacteria from a depressed mouse to a healthy one was enough to induce depressive behaviours in the recipient (Zheng et al., 2016).

Early human studies echo these findings. In small clinical trials, faecal microbiota transplants (FMT) from non-depressed donors temporarily improved depressive symptoms in treatment-resistant patients (Valles-Colomer et al., 2019). While the idea of “transplanting happiness” remains more metaphorical than practical, these results demonstrate a powerful biological truth: our emotional wellbeing is influenced by the microbial conversations happening below the diaphragm.

When the microbiome loses diversity, certain gut bacteria begin releasing pro-inflammatory cytokines, immune messengers that signal distress throughout the body. The brain interprets these signals as threat or fatigue, activating neural circuits associated with low mood, lethargy, and loss of pleasure. In this way, inflammation acts as a bridge between gut imbalance and emotional imbalance (Miller and Raison, 2016).

Conversely, cultivating a healthy and varied microbiome supports resilience. Factors that enhance microbial diversity include:

A fibre-rich, plant-based diet with fermented foods and minimal ultra-processed ingredients.
Regular aerobic exercise, which increases microbial species richness.
Consistent sleep patterns, since gut flora follow circadian rhythms of their own.

The connection between gut health and depression is not just theoretical. The landmark SMILES trial (Jacka et al., 2017) demonstrated that a Mediterranean-style diet, rich in whole grains, legumes, vegetables, and olive oil, reduced depressive symptoms by about 30% within twelve weeks. Importantly, these improvements were independent of social support, confirming that what we eat can influence mood directly through biological pathways.

This evolving field, sometimes called nutritional psychiatry, reframes mental health as an ecosystem problem rather than a purely chemical one. As the NeuroAffective-CBT® model suggests, emotional regulation is an embodied skill, a dialogue between body, brain, and affect (Mirea, 2023). The gut microbiome, communicating through the vagus nerve and immune signalling, is an active participant in that dialogue.

When we eat poorly, we’re not just starving our bodies; we’re silencing billions of microscopic allies whose job is to keep our minds in balance. Rebuilding that internal community is therefore not just a digestive act, it is an act of self-care, a physiological form of emotional literacy.

TED Takeaway: A healthy mind begins in a healthy gut. Diversity in your diet builds diversity in your emotions. Feed the bacteria that help you feel alive.


Feeding the Mind from the Inside Out

How Nutrition Speaks the Language of Emotion

If the gut is a second brain, then every meal is a message. What we eat doesn’t just fill us, it informs us, shaping mood, motivation, and resilience through a constant biochemical dialogue between microbes and mind. In the NeuroAffective-CBT® model, this represents the living interface between body, brain, and affect: the nutritional conversation that regulates how we feel and function (Mirea, 2023).

When we eat well, the gut microbiome flourishes. Beneficial bacteria such as Lactobacillus and Bifidobacterium convert dietary fibre and complex carbohydrates into short-chain fatty acids like butyrate, which reduce inflammation and support the integrity of the gut lining (Cryan et al., 2019). These molecules also cross into the bloodstream, where they influence brain chemistry, increasing serotonin and BDNF (brain-derived neurotrophic factor), both critical for stable mood and cognitive flexibility.

By contrast, processed foods rich in refined sugar and saturated fats feed inflammatory microbes, producing cytokines that weaken the gut barrier and signal distress to the brain (Miller and Raison, 2016). The emotional fallout can manifest as irritability, fatigue, and a sense of mental fog – the psychological shadow of biological inflammation.

The Role of Prebiotics and Probiotics

Two categories of food play an especially important role in nurturing the gut–brain connection: prebiotics and probiotics.

Prebiotics are the fibres that feed beneficial bacteria, found abundantly in garlic, onions, oats, bananas, walnuts, and polyphenol-rich foods like olive oil, berries, and red grapes. Regular consumption of these foods maintains a diverse microbial population, strengthening the body’s immune and emotional defences (Gibson et al., 2017).

Probiotics, by contrast, are the bacteria themselves, living microorganisms that, when consumed in sufficient quantities, support the health of the microbiome. These are found in fermented foods such as yoghurt, kefir, sauerkraut, miso, tempeh, and kombucha. When ingested regularly, probiotics can influence the production of neurotransmitters like GABA, the calming chemical that reduces anxiety and promotes relaxation (Sarkar et al., 2016).

Because of their measurable effect on mental health, some clinicians now call these organisms psychobiotics, living agents that support psychological wellbeing through the gut–brain axis (Dinan et al., 2013).

Timing, Movement, and Mindfulness

Timing matters too. Probiotic capsules and fermented foods are most effective when taken on an empty stomach or before a light meal, allowing beneficial bacteria to pass through the stomach’s acidic environment without being destroyed (Appleton, 2018).

Movement also plays a part. Aerobic exercise, brisk walking, cycling, swimming, improves microbial diversity, enhances vagal tone, and increases BDNF, reinforcing both mental and emotional resilience (Biddle et al., 2019). Likewise, consistent sleep supports microbial rhythms that align with the circadian cycle, anchoring energy and emotional stability.

Finally, mindfulness serves as the behavioural amplifier of this entire system. Paying attention to what and how we eat, slowing down, tasting, and breathing, activates the parasympathetic nervous system via the vagus nerve, enhancing digestion and emotional regulation. Mindful eating isn’t a trend; it’s neurobiology in action (Goldin and Gross, 2010).

The Emotional Ecology of Eating

Each meal is both nourishment and feedback. The brain interprets the gut’s chemical and mechanical signals, fullness, acidity, nutrient quality, and translates them into emotion. When the body says safe, the mind feels calm. When the body says threat, the mind feels uneasy. Over time, the foods we choose either reinforce stability or erode it.

In this sense, food is not just nutrition; it’s participation in a living ecosystem, one that rewards diversity, balance, and attention. The microbiome is not a silent partner; it is a dynamic community that mirrors how we live. A chaotic diet creates inner noise. A mindful one restores harmony.

TED Takeaway: Care for your microbes as you would a garden: feed them, move with them, let them rest. They return the favour with energy, clarity, and emotional balance. Mindfulness is not a trend; it’s neurobiology in action.


Diet and Depression: What the SMILES Trial Taught Us

How Food Became a Form of Therapy

For decades, the relationship between food and mood has been treated as secondary, a lifestyle footnote rather than a therapeutic pathway. Yet emerging evidence now places diet at the centre of mental health. The food on your plate can influence neurotransmitters, inflammation, neuroplasticity, and ultimately, your emotional resilience.

The clearest demonstration of this came from Australia in 2017, when Professor Felice Jacka and her team published the landmark SMILES Trial (Supporting the Modification of lifestyle in Lowered Emotional States). The study asked a deceptively simple question:
“Could changing one’s diet treat depression as effectively as conventional therapies?”.

A New Kind of Antidepressant

The researchers recruited adults diagnosed with major depressive disorder and divided them into two groups. One group received regular social support sessions, conversation, connection, and empathy. The other met with a dietitian who guided them through a modified Mediterranean diet, rich in vegetables, fruits, legumes, whole grains, fish, and olive oil, while minimising processed foods, sugar, and refined carbohydrates (Jacka et al., 2017).

After twelve weeks, the results were striking. The diet group showed a 32% reduction in depressive symptoms, compared to only 8% in the social-support group. Roughly one in three participants in the dietary intervention achieved full remission from depression, without medication changes.

Follow-up research (Opie et al., 2018; Lai et al., 2013) replicated these findings: when we nourish the brain with anti-inflammatory foods and micronutrients that enhance serotonin, dopamine, and BDNF, mood stabilises and cognition sharpens. The Mediterranean diet wasn’t simply helping people feel better; it was changing their biology.

Why It Works: Inflammation and Neuroplasticity

The mechanism is now clearer. Diets high in refined sugar, processed fats, and artificial additives trigger systemic inflammation, increasing pro-inflammatory cytokines that interfere with neurotransmitter metabolism (Miller and Raison, 2016). Chronic inflammation dampens neuroplasticity, the brain’s ability to form and strengthen neural connections, especially in regions like the hippocampus and prefrontal cortex, both vital for motivation and emotional regulation.

In contrast, Mediterranean-style diets are anti-inflammatory. They deliver omega-3 fatty acids, polyphenols, antioxidants, folate, and B-vitamins, all of which support synaptic growth, mitochondrial health, and neurotransmitter balance (Marx et al., 2017). Within days, high-quality nutrition can raise levels of BDNF, a protein that acts as fertiliser for neurons, improving learning, memory, and emotional flexibility (André et al., 2008).

In NeuroAffective-CBT®, this biological process mirrors the therapeutic one: both involve rewiring, re-establishing communication between disrupted neural circuits. When inflammation drops and BDNF rises, the emotional brain becomes more responsive to therapy, mindfulness, and behavioural change (Mirea, 2023). Diet doesn’t replace psychotherapy; it prepares the terrain for it.

Food as Behavioural Change

From a behavioural perspective, modifying diet is itself a neuroaffective intervention. Choosing whole foods over processed ones engages the prefrontal cortex, the brain’s executive centre, and strengthens self-regulation circuits. This is the same cognitive–emotional skill that therapy trains: recognising impulses and acting intentionally. Each meal becomes an opportunity to practise regulation, reward delay, and self-care.

Moreover, eating well reinforces a positive feedback loop. Balanced blood sugar and nutrient-rich foods stabilise the autonomic nervous system, calming the vagus nerve and reducing emotional reactivity. Over time, people report not only better mood but also a greater sense of clarity and motivation, biological calm translating into psychological coherence.

The SMILES trial and subsequent studies remind us that emotional healing can begin with something as ordinary as lunch. A colourful plate may be the most accessible form of neurochemistry we possess.

TED Takeaway: Changing what’s on your plate can change what’s on your mind. Food is the most consistent, self-administered antidepressant you’ll ever take.


Inflammation, Neuroplasticity, and the Healing Brain

How the Body’s Chemistry Shapes the Mind’s Resilience

For most of the twentieth century, depression was described as a chemical imbalance, a deficiency of serotonin, dopamine, or noradrenaline that could be corrected with medication. That model helped reduce stigma and offered effective treatments for many, but it left out something crucial: why those chemical imbalances occurred in the first place.

Over the past two decades, neuroscience has reframed this understanding. We now know that depression and anxiety are not simply deficits in neurotransmitters but disorders of connectivity and plasticity. In other words, the problem lies not only in the chemicals themselves, but in the wiring that allows brain cells to communicate (Duman and Duman, 2015; Serafini, 2012).

The Fire Within: How Inflammation Shapes Emotion

Inflammation is the body’s ancient alarm system; a protective mechanism designed to fight infection and heal injury. But when the immune system becomes overactive through chronic stress, poor diet, or environmental toxins, this inflammation becomes systemic. Pro-inflammatory cytokines like IL-6 and TNF-α flood the bloodstream and reach the brain, where they disrupt neurotransmission, reduce serotonin availability, and interfere with energy metabolism in neurons (Miller and Raison, 2016).

This inflammatory “fog” particularly affects the hippocampus and prefrontal cortex, regions crucial for motivation, memory, and self-reflection. Inflammation shrinks dendritic spines, weakens synapses, and slows the birth of new neurons, a process called neurogenesis (Kang et al., 2012). The result is a brain less capable of flexibility, learning, and emotional recovery.

But here lies the hopeful paradox: if the brain can become unwell through maladaptive plasticity, it can also heal through adaptive plasticity. The very circuits that fall silent under inflammation can reignite when nourished, exercised, and engaged through therapy.

Food as Neural Fertiliser

Anti-inflammatory diets, particularly Mediterranean-style nutrition, provide the building blocks for neuroplasticity. Omega-3 fatty acids, B-vitamins, folate, and antioxidants all contribute to the production of Brain-Derived Neurotrophic Factor (BDNF), a protein that promotes the growth and repair of synaptic connections (André et al., 2008).

In both humans and animals, increased BDNF correlates with reduced depressive symptoms and enhanced learning capacity (Duman and Duman, 2015). Even more striking, changes in BDNF can occur within days of improving diet, exercise, or sleep patterns (Serafini, 2012). Antidepressant medications, mindfulness training, and aerobic activity all elevate BDNF through similar pathways, demonstrating that biological and psychological interventions converge on the same neural mechanisms (Yang et al., 2016).

This overlap helps explain why the NeuroAffective-CBT® model emphasises a multi-system approach: emotion, cognition, and physiology are not separate domains but parallel feedback loops. When diet reduces inflammation, therapy becomes more effective. When therapy enhances self-regulation, it reduces physiological stress. The brain heals through both bottom-up and top-down signals, food and thought working in tandem.

The Practice of Rewiring

In clinical terms, neuroplasticity means that the brain can literally change its structure in response to experience. New synapses form as we learn, and old, unused ones dissolve. This principle, “neurons that fire together wire together”, describes both learning and healing.
Every act of mindful eating, exercise, or reframed thought in therapy strengthens certain circuits and weakens others. Over time, these microscopic changes accumulate into a macroscopic shift in emotional stability. Healing is not a switch; it’s a training process, a gradual re-sculpting of the brain’s networks through repeated experience.

From Inflammation to Integration

Understanding depression as an inflammatory and connectivity disorder allows us to see recovery as a process of integration, not correction. The goal is not to “fix” a broken brain but to create the conditions, nutritional, psychological, and relational, in which it can heal itself.

When inflammation subsides, BDNF rises, and neuroplasticity reawakens, the brain regains its natural rhythm of adaptation. The world begins to look different not because it has changed, but because the neural machinery perceiving it has been renewed.

TED Takeaway: Depression isn’t just in your mind it’s in your wiring. Reduce inflammation, nourish your brain, and practise new ways of thinking: that’s how neurons learn hope.


Energy, Glucose, and the Emotional Roller-Coaster

How Blood Sugar Shapes Behaviour and Mood

Every emotion has a metabolic signature. The brain’s ability to focus, regulate mood, or recover from stress depends on a steady supply of energy, and that energy runs almost entirely on glucose. Yet, like a child on a sugar high, our modern diets deliver glucose in erratic bursts rather than balanced waves.
The result is what many of us recognise intuitively: the mid-morning energy crash, the irritability that accompanies hunger, or the brain fog after a sugary lunch. These are not signs of weak willpower but of metabolic turbulence – fluctuations in blood sugar that the brain interprets as emotional instability.

The Brain’s Hunger for Balance

Although the brain represents only about 2% of body weight, it consumes nearly 20% of all glucose available in the bloodstream (Mergenthaler et al., 2013). Because it cannot store much energy, even brief drops in blood sugar can trigger fatigue, distractibility, or irritability. Conversely, sharp glucose spikes from refined carbohydrates or sweetened drinks cause transient dopamine surges followed by cortisol rebounds, leading to the emotional equivalent of a sugar hangover (Ludwig, 2002).

These rapid fluctuations affect the prefrontal cortex – the region responsible for self-control, focus, and emotional regulation. When glucose levels fall too low, this part of the brain becomes less efficient, and impulsive, reactive behaviours take the lead (Gailliot and Baumeister, 2007). In NeuroAffective-CBT® terms, this is when cognitive regulation gives way to affective overwhelm, when physiology outpaces psychology.

The Glucose–Mood Connection

Clinical evidence supports this link. People with insulin resistance or poorly controlled blood sugar show higher rates of depression and anxiety, while those who stabilise glucose through diet and exercise experience improved mood and cognitive function (Luo et al., 2022). Chronic glucose variability increases oxidative stress and inflammatory cytokines, which impair both neuronal health and neurotransmitter balance — especially serotonin and dopamine, the “mood messengers” that govern motivation and reward (Treadway and Zald, 2011).
In practical terms, mood stability often mirrors glucose stability. A diet rich in whole grains, fibre, protein, and healthy fats slows digestion and moderates glucose absorption. This prevents extreme highs and lows, sustaining steady energy to the brain throughout the day. The difference may feel subtle, fewer cravings, clearer thinking, a calmer baseline, but over time, these micro-adjustments translate into significant emotional resilience.

How to Flatten the Curve

Small, mindful habits can smooth the emotional and metabolic roller-coaster:

Start the day savoury. A protein-based breakfast (e.g., eggs, yoghurt, or nuts) reduces morning glucose spikes and keeps dopamine stable through the first stressors of the day.
Eat vegetables before starch. Fibre and phytonutrients slow carbohydrate absorption, flattening post-meal glucose peaks (Jovanovic et al., 2009).
Walk for ten minutes after meals. Even light physical movement enhances insulin sensitivity and improves glucose uptake, translating into a calmer nervous system.
Avoid “naked carbs.” Pair carbohydrates with protein or fat to delay glucose release and prevent sharp insulin responses.

These strategies are not merely nutritional tricks, they are self-regulation tools. They train the body to maintain equilibrium, and the brain to interpret safety instead of scarcity.

From Sugar Spikes to Emotional Stability

When blood sugar stabilises, the body–brain–affect loop settles into coherence. The vagus nerve signals calm, the limbic system reduces alarm responses, and the prefrontal cortex resumes executive control. In this synchrony, the emotional brain becomes less volatile and more available for reflection, empathy, and learning, the core functions of psychological growth.

From a NeuroAffective-CBT® perspective, managing glucose is a form of embodied mindfulness: paying attention to the body’s energy patterns and adjusting behaviour to sustain internal balance. It’s not a diet; it’s emotional literacy in biochemical form.

TED Takeaway: Flat glucose curves make flat emotional seas. Balance your blood sugar to balance your behaviour, stability in biology creates stability in being.


The Body Remembers What the Mind Forgets

Integration as the Final Language of Healing

By now it is clear that mental health is not confined to the skull. The mind is not a separate entity floating above the body; it is a conversation within it — a continuous feedback loop between cells, organs, microbes, and meaning. Every thought has a heartbeat. Every emotion has a chemical echo.

In NeuroAffective-CBT®, we call this the body–brain–affect triangle, a living system of regulation in which physiology, cognition, and feeling inform one another. When that dialogue is coherent, we experience emotional balance and clarity. When it breaks down through exhaustion, poor diet, or chronic stress, the body begins to speak in symptoms the mind may not yet understand.

The Biology of Memory and Emotion

The body remembers what the mind forgets because experience is not stored in words but in networks: of neurons, hormones, and sensations. Emotional memories, joy, fear, loss, are distributed across the nervous system, woven into posture, breathing, digestion, and sleep. Chronic inflammation, unstable glucose, or poor gut health can reactivate these circuits, producing what feels like psychological distress but is, in fact, physiological dissonance.

Conversely, when we restore the biological foundations of safety, balanced nutrition, restorative sleep, consistent movement, the same networks become available for reprocessing through therapy and reflection. The emotional brain can only heal when the body feels safe enough to listen.

This is why the TED framework (Tired, Exercise, Diet), is more than a lifestyle checklist. It is a neurobiological protocol for emotional coherence. By regulating fatigue, movement, and nutrition, we restore the stability that allows higher cognition – empathy, creativity, and self-awareness, to flourish (Mirea, 2023).

From Self-Regulation to Self-Understanding

Healing begins with self-regulation but matures into self-understanding. Each meal, each breath, each night of sleep becomes a message to the nervous system: You are safe enough to grow. When inflammation recedes, BDNF rises, and neural connections strengthen, therapy deepens. Mindfulness becomes easier. The world feels less like a threat and more like an invitation.

In this light, diet is not only about nutrients; it is about relationship with one’s body, with the environment, and with others. Sharing food, preparing it mindfully, and consuming it with gratitude engage ancient neural pathways of belonging and calm. The microbiome thrives not just on fibre and polyphenols but on human connection itself.

The Integration of Knowing and Feeling

Modern neuroscience and ancient wisdom converge on the same insight: we cannot think our way out of a dysregulated body. Emotional regulation begins in the viscera, in the gut that senses, the heart that signals, the breath that synchronises. The task of psychotherapy, then, is not to escape biology but to integrate it, to build bridges between inner experience and outer awareness.
When the mind listens to the body, and the body trusts the mind, coherence emerges. This is the moment when therapy, nutrition, and neuroscience meet, not as separate disciplines, but as languages of the same truth: that to feel well, we must live in alignment with what our biology has always known.

TED Takeaway: The state of your gut is the tone of your thoughts. Heal one, and the other learns to sing again.


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TED Series – Part VII: Physical Exercise, Sports Science and Mental Health

Daniel Mirea (October 2025)
NeuroAffective-CBT® | https://neuroaffectivecbt.com


Abstract

In this seventh instalment of the TED (Tired–Exercise–Diet) Series, we explore the neuroscience of physical exercise and its central role in emotional regulation, cognitive function, and mental health.

Within the NeuroAffective-CBT® (NA-CBT) framework, exercise represents the “E” in TED – the second pillar of biological stability upon which self-regulation and psychological flexibility depend.

This chapter presents both theoretical foundations and practical guidance for integrating physical and relaxation training, circadian rhythm alignment, and behavioural activation into therapeutic practice.

Drawing from sports science, neuroendocrinology, and behavioural neuroscience, it outlines evidence-based applications for enhancing biological resilience and emotional regulation.

Ultimately, this instalment concludes the biological foundations of the TED model, offering clinicians a cohesive framework for embedding exercise-related interventions into the NeuroAffective-CBT® therapeutic process.

A glossary of key terms is provided at the end of the article to support comprehension and deepen the reader’s learning experience.


Introducing TED within the NA-CBT® Framework

The TED model (Tired–Exercise–Diet) integrates neuroscience, psychophysiology, and behavioural science into a cohesive structure for promoting emotional regulation and biological stability. Within NeuroAffective-CBT®, TED forms the foundation of the Body–Brain–Affect Triangle, a conceptual model linking physiology, cognition, and emotion (Mirea, 2023; Mirea, 2025).

Earlier instalments in this series examined six primary regulators of mood and cognition:

Creatine (Part I)
Insulin Resistance (Part II)
Omega-3 Fatty Acids (Part III)
Magnesium (Part IV)
Vitamin C (Part V)
Sleep (Part VI) – the neurobiology of fatigue and recovery within the Tired pillar

This chapter extends the model to the “Exercise” component, the dynamic driver of both physical and psychological resilience, while revisiting Tired through the lens of sleep neuroscience and affect regulation to underscore their interdependence within NeuroAffective-CBT®.


The “E” – Exercise as the Biological Catalyst

E” stands for Exercise, a symbol of physical strengthening and a reminder that movement is integral to human adaptability and emotional balance. Evidence consistently demonstrates that regular physical activity not only boosts immunity but also regulates hormones, enhances protein synthesis (similarly to sleep), and supports the management and prevention of a wide range of mental health conditions (Nieman, 2018; Mahindru, 2023; Mennitti et al., 2024; Strasser, 2015; Deslandes, 2014).

The forthcoming section, “D”, will explore the relationship between muscle size and glucose regulation, providing further evidence that muscle-strengthening activity exerts measurable effects on both body and mind. This connection is deeply evolutionary. Humans were not designed for sedentary living or sugar-rich diets but for creative movement, exploration, and endurance. It was this unique blend of curiosity, resilience, and physical vitality that allowed humans to survive, innovate, and thrive.

TED Takeaway:
Movement restores synchrony between body, brain, and affect.
• Exercise is not ancillary to therapy; it is a biological stabiliser and an emotional educator.


Exercise, Adaptation, and Individualisation

To sustain motivation and promote long-term adherence, physical strengthening programmes should always be individualised, taking into account differences in age, sex, current physical condition, as well as personal preferences and cultural values.

Research consistently shows that when physical activity is enjoyable and personally meaningful, when it connects to an individual’s goals, such as improved strength, confidence, or self-image, both physical and psychological outcomes are significantly enhanced. A foundational paper in Self-Determination Theory by Deci and Ryan (2000) demonstrated that intrinsic motivation – the sense of enjoyment, personal meaning, and autonomy, predicts adherence and well-being across multiple domains, including physical activity, while a comprehensive review by Teixeira et al. (2012) further confirmed that autonomous motivation and enjoyment are key predictors of both exercise adherence and psychological benefit.

Within the NeuroAffective-CBT® framework, exercise recommendations integrate both muscle activation (tensing or strengthening) and muscle relaxation practices. What contracts must also release – this natural cycle of tension and relaxation supports recovery, balance, and emotional regulation.

This principle is exemplified in Progressive Muscle Relaxation (PMR), first introduced by Edmund Jacobson in the 1930s (Jacobson, 1938). PMR combines focused attention with abdominal breathing, guiding individuals through cycles of tensing and releasing specific muscle groups. Over time, this practice develops interoceptive awareness – the ability to sense and modulate bodily tension, recognise signs of stress, and release it through mindful breathing. More recent research shows that enhancing interoceptive awareness can also improve attentional control, focus, learning capacity, and ultimately cognitive flexibility, key components of adaptive emotional regulation and psychological resilience (Farb, Segal and Anderson, 2013; Schulz, 2016).

  • Martial arts training supports individuals struggling with confidence, assertiveness, or low self-esteem, blending controlled power with discipline and focus.
  • Team sports are often beneficial for those with social anxiety, providing gradual social exposure within structured, cooperative settings.
  • Yoga: effective for stress regulation and interoceptive awareness, with added benefits for mobility and strength depending on style (e.g., Hatha/Iyengar for alignment and control; Vinyasa/Ashtanga for conditioning). Can be prescribed on its own or as an adjunct to any of the above. Consider trauma-sensitive formats when relevant; introduce load and range progressively, and use care with generalised hypermobility (prioritise stability and pain-free ranges).
  • Culturally rooted movement practices, such as Capoeira in Brazil, Tai Chi in East Asia, or traditional dance forms found in many Indigenous and Mediterranean cultures, can serve as powerful, identity-affirming exercises. These activities not only promote physical health but also reinforce cultural belonging, foster feelings of acceptance, and build community connection. Such practices can be particularly beneficial for individuals experiencing social isolation or depression, as they combine movement, rhythm, and shared meaning — all of which strengthen emotional resilience and a sense of self within a social context (Koch et al., 2019; Li et al., 2012).
  • For clients with Body Dysmorphic Disorder (BDD), bodybuilding requires careful framing and monitoring; appearance-driven goals can reinforce maladaptive self-evaluation, whereas performance-based strength training may be safer.

Modern therapeutic approaches such as Grounding, Mindfulness-Based Stress Reduction (Kabat-Zinn, 2003), or Mindfulness-Based Cognitive Therapy (Segal, Williams, and Teasdale, 2002) share this same purpose: enhancing body awareness, recalibrating neurophysiological responses, and strengthening emotional self-regulation.

Ideally, when physical health permits, one should train daily, alternating between activation (strength or resistance training) and relaxation (PMR, Grounding or Mindfulness) to maintain both physical tone and emotional equilibrium.

TED Takeaway:
Pair strength with release (PMR/yoga/mindfulness) to preserve the physiological rhythm of activation–recovery.
• Practical cadence (health permitting): train most days, alternating activation (20–40 min) and relaxation (10–20 min) to maintain tone and equilibrium.
• Enjoyment and meaning are not optional; they are mechanisms of adherence and benefit.


Condition-Specific Exercise: Matching Movement to Mind

Certain exercise modalities align particularly well with specific emotional or cognitive profiles, provided they are introduced with gradual exposure and incremental goals that promote both physical and psychological growth.

Therapeutic exercise selection should always remain person-centred, attuned to both psychological needs and affective drivers of behaviour, while respecting individual and cultural identity.

TED Takeaway:
Match the modality to the mechanism you want to train (confidence, social approach, cultural belonging, stress regulation).
• Keep exposure graded and goals process-focused; adjust style and dose to the person.


NA-CBT Tools for Performance Priming

  1. Breathing, Attention & Arousal Regulation:

Your breathing pattern is one of the fastest ways to change how alert, focused, or calm your body feels, it’s a direct link between the body, brain, and emotions. In simple terms, how you breathe sends a signal to your nervous system about whether it’s time to perform or recover.

When you need to up-regulate, that is, increase alertness, focus, and readiness before a challenging effort, try short, sharp inhales or slightly constrained exhales.
This kind of breathing activates your body’s sympathetic nervous system (the get up and go system), increasing blood flow, oxygen delivery, and mental sharpness.

For example:

• Before a sprint, lift, or high-intensity set, take two or three quick inhales through the nose and one strong exhale through the mouth.
• You’ll feel your heart rate rise and your focus sharpen, your body preparing to perform.

Then, between sets or after the workout, you want to down-regulate, to shift into recovery mode. This is when you lengthen your exhales or practise relaxation methods such as Progressive Muscle Relaxation (PMR) or breathing and stretching. Long, slow breaths stimulate the parasympathetic nervous system, your “rest and repair” mode, lowering heart rate, easing muscle tension, and improving focus for the next round.

In essence, your breath acts like a volume dial for your nervous system:

Faster or shallower breathing turns up the system for performance.
Slower, deeper breathing turns it down for recovery and calm.

Learning to consciously move between these two physiological states – activation and recovery – strengthens both performance and resilience. These principles align closely with findings in applied sport psychology, where self-regulation of attention and arousal is central to maintaining consistent, high-level performance (Weinberg and Gould, 2019).

Over time, this skill becomes a cornerstone of self-regulation training within the NeuroAffective-CBT® framework, linking movement, breath, and attention into one coherent system for emotional and physical balance.

2. High-Signal Tools: Music, Caffeine, and Nootropics

Tools such as caffeine, motivational music, or cognitive enhancers (nootropics) can provide a powerful mental and physical boost before exercise. However, the nervous system adapts quickly to these high-signal aids. When they are used in every session, their effects diminish over time, and motivation can begin to depend on them rather than arise naturally.

To prevent this tolerance effect, reserve high-signal tools for key or demanding training days rather than routine sessions. This aligns with the signal-to-noise principle in neuroscience: when stimulation (the signal) becomes constant, the brain starts to tune it out (increasing noise).

TED Takeaway: Using these tools strategically preserves their potency and supports the development of intrinsic focus and self-regulation. Typical caffeine guidance is around 1–3 mg per kilogram of body weight, avoiding late-evening doses. Always consider potential interactions or contraindications (e.g., anxiety, hypertension, pregnancy, or psychotropic medication use).

3. Boundaries that Prime Intent and Focus

Setting a physical or mental threshold before training, such as drawing a line on the floor, standing at the gym door, or taking a moment before stepping onto a platform, can significantly improve performance. This small ritual tells the brain, “I’m about to begin something important“.

Crossing that boundary only when mentally ready acts like a psychological switch, heightening attention, intention, and effort quality. It helps athletes transition from everyday distraction into a state of focused readiness, where the body and mind align for optimal performance.

In practice, this is less about superstition and more about neuro-behavioural priming, conditioning the brain to associate a specific action (crossing the line) with focus and engagement. Over time, this can strengthen self-regulation and consistency, even on low-motivation days.

TED Takeaway:
Faster, shallower breathing → performance state.
• Slower, longer-exhale breathing → recovery state.
• Save high-signal tools for important sessions to preserve their potency and your intrinsic drive.
• A brief pre-set boundary ritual improves consistency and effort quality.


Body Temperature & Performance

The body’s ability to maintain an optimal temperature range influences far more than endurance — it also affects motivation, muscle efficiency, and mental focus.

A lesser-known but fascinating fact is that glabrous skin – the hairless, thick skin found on the palms, soles, and parts of the face (such as the lips and nasal area) – plays a key role in thermoregulation. These regions are rich in arteriovenous anastomoses (AVAs), specialised blood vessels that allow rapid heat exchange. This is why the hands, feet, and face are particularly effective for cooling or warming the body.

This understanding may also shed light on certain ancestral behaviours, such as the instinctive human tendency to touch natural surfaces or another person’s skin to gauge warmth, comfort, or safety, an evolutionary remnant of how we once regulated both physical and emotional connection through touch.

Research shows that palmar cooling (cooling the hands between sets or during endurance exercise) can substantially increase work output in hot conditions, while reducing thermal fatigue and improving recovery (Grahn, Cao & Heller, 2005; Heller, 2010).

Interestingly, Dialectical Behaviour Therapy (DBT), a third-wave CBT approach developed by Marsha Linehan, also uses temperature-based interventions for emotional regulation. During states of high emotional arousal, clients are taught to cool the body rapidly using ice packs on the face or brief facial immersion in cold water. This activates the mammalian dive reflex, which lowers heart rate and stimulates the parasympathetic nervous system, producing a powerful calming effect (Linehan, 2014).

When the body overheats, muscles work less efficiently, excessive heat disrupts energy production. As temperature rises, the chemical reactions that generate energy through adenosine triphosphate (ATP) begin to falter. A key enzyme in this process, pyruvate kinase, which helps convert fuel into usable energy, slows down or even stops functioning properly. The result is simple: overheated muscles fatigue faster, lose power, and overall performance declines.

Conversely, controlled cooling helps sustain endurance and recovery by maintaining thermal balance. The palms, soles, and face act as natural radiators through their AVAs, enabling rapid heat dissipation and stabilising core temperature.

Simple practical methods include holding cool (not ice-cold) objects or briefly immersing the hands or feet in cool water between training bouts. This straightforward approach can lower perceived effort, extend training capacity, and accelerate post-exercise recovery.

These findings reinforce the importance of temperature regulation as part of recovery and emotional self-regulation within the TED framework.

TED Takeaway:
Gentle cooling after exercise helps the body shift more quickly into recovery mode by supporting the parasympathetic nervous system, which governs rest, repair, and relaxation.
• Rinsing the hands, feet, or face with cool water after exercise stabilises heart rate and calms the body within 30–60 minutes, improving recovery and emotional balance.
• Excessive or immediate full-body cold exposure — such as jumping straight into an ice bath — can interfere with the body’s mTOR repair signalling, slowing muscle growth and adaptation.
• In short: a little cooling helps the body recover faster, but too much too soon can blunt the benefits of training.
Safety note: Cold immersion should be avoided in cases of unmanaged cardiovascular disease, severe Raynaud’s, or neuropathy; seek medical guidance if unsure.


Cortisol isn’t the enemy: time it, don’t flatten it

Because cortisol often rises during stress or anxiety, it’s sometimes misunderstood as purely harmful. In reality, short-term cortisol spikes after training are vital, they mobilise fuel, drive adaptation, and signal recovery.


The goal is rhythmic spikes that return to baseline, not chronic elevation.
Blunting cortisol too early, through overuse of supplements, anti-inflammatories, or excessive carbohydrates, can impair muscle repair. Instead, allow cortisol to rise during exertion and fall gradually post-training. Strategically timed carbohydrate intake can facilitate this recovery phase by naturally lowering cortisol while replenishing glycogen stores and improving sleep quality.

Heart rate (HR) and heart rate variability (HRV) help monitor stress–recovery balance. Low HRV or chronically elevated HR may signal overtraining, poor sleep, or psychological stress. Moderate, consistent exercise combined with rest, hydration, and mindfulness restores autonomic balance and resilience.

TED Takeaway:

Evening or post-training carbohydrates (prefer minimally processed, starchy sources) can assist cortisol down-shifting, support sleep, and replenish glycogen.
• Avoid overuse of “cortisol blockers” heavy alcohol, or sedative strategies, as they can impair adaptation and sleep architecture.


Mirrors, Interoception, and Motor-learning

Technological aids such as mirrors or video feedback can be useful in the early stages of learning new movements. They help individuals understand form and alignment, but the ultimate goal is a felt sense of movement, awareness that comes from within, rather than dependence on external feedback.

Hypertrophy focus (muscle growth and strengthening): Using a mirror occasionally or posing between sets can improve body awareness and help engage the target muscles more effectively during training.

Speed or skill learning (e.g., Olympic lifts, sprints): Avoid mirrors, as they shift attention outward and reduce interoceptive awareness, the ability to sense and adjust body position and movement internally.

TED Takeaway:

Mirrors and video feedback can support early learning, but lasting skill comes from internal awareness.
• Develop a felt sense of movement – coordination and control without reliance on external cues.


Train Recovery and Relaxation: The Pathway to Physiological Resilience

Like any other skill, the ability to switch off, relax, and recover can be trained. Recovery is not fixed, it can be strengthened over time. Just as you build muscle through progressive challenge, you can train your recovery systems by occasionally pushing slightly beyond what feels comfortable (in a safe and controlled way). Each small, well-managed challenge helps your body and mind learn to adapt to stress more effectively.

To build this kind of resilience, focus on the fundamentals:

  • Keep your sleep regular. Get morning light to wake your system and dim evening light to prepare for rest.
  • Eat well. Make sure you’re getting enough energy, protein, and hydration to help your body repair itself.
  • Use temperature wisely. Short, gentle exposures to heat or cold (with enough rest between) train your body to adapt to different environments.
  • Stay connected and mindful. Supportive relationships, journaling, mindfulness, or relaxation exercises such as Progressive Muscle Relaxation (PMR) all help keep your nervous system flexible and balanced.

This rhythmic cycle of effort and restoration forms the biological basis of resilience within the TED framework, teaching the body to recover as deliberately as it performs.

TED Takeaway:

Use graded, manageable challenges to expand capacity — always with control and recovery.
• In NeuroAffective-CBT®, this reflects a core principle: gradual, intentional exposure to small challenges increases the ability to cope with stress while maintaining emotional balance and self-regulation.


Conclusion

Exercise is more than physical conditioning; it is a biological and emotional regulator – a living interface between movement, emotion, and cognition. Behavioural principles long recognised this: Lewinsohn’s model linked reduced engagement with loss of reinforcement; Behavioural Activation (Jacobson, Martell & Dimidjian, 2001) reinstated purposeful activity; Beck’s cognitive therapy integrated behavioural experiments, graded tasks and activity scheduling (Beck et al., 1979).

Within the NeuroAffective-CBT® model, the “E” in TED symbolises this central truth: emotional stability and cognitive clarity arise not in isolation, but through the synchrony of body and mind.

The TED framework demonstrates that emotional regulation is not achieved through thought alone, but through the rhythmic cooperation of the body’s systems, when we are tired, exercised, and nourished in balance. In essence, exercise functions both as a biological stabiliser and an emotional educator, a continuous dialogue between movement, mood, and meaning.

The TED model reminds us that resilience is not a fixed trait but a rhythm, cultivated through synchrony, when the body rests, moves, and restores itself in harmony.

In the forthcoming and final section, “D”, we will complete the TED model by exploring Diet, the biochemical cornerstone of mental health, and its interdependent relationship with exercise, sleep, and emotional regulation.


Ten TED Takeaways: Physical Exercise and Mental Health

  1. Movement is Medicine. Exercise is a biological necessity that supports immunity, hormone balance, protein synthesis, and emotional regulation.
  2. Cortisol is adaptive, not destructive. It should rise during exertion and fall during recovery.
  3. Evolution Favouring Motion. Human physiology is designed for activity. Movement restores the natural synchrony between body, brain, and affect.
  4. Balance Between Tension and Release. Strength must coexist with recovery. PMR, yoga, and mindfulness sustain this physiological rhythm.
  5. Exercise as Emotional Education. Physical training teaches the body–mind connection, transforming tension into awareness and control.
  6. Personalised Movement and Training. Match the type or exercise modality to the person: martial arts for confidence, team sports for social anxiety; use caution with appearance-driven training in BDD.
  7. Embodied Self-Regulation. Within NeuroAffective-CBT®, exercise is the “E”, the biological catalyst linking movement with mood and self-regulation.
  8. Use “high-signal” tools sparingly. Keep caffeine, music, and stimulants for key days to maintain their effect.
  9. Intentional boundaries prime the mind. Physical thresholds before training enhance focus and effort quality.
  10. Integration, Not Isolation. Emotional stability requires synergy between Tired, Exercise, and Diet – rest, movement, and nourishment.

References

Biddle, S.J.H. and Asare, M. (2011) ‘Physical activity and mental health in children and adolescents: a review of reviews’, British Journal of Sports Medicine, 45(11), pp. 886–895.

Blumenthal, J.A. et al. (2012) ‘Exercise and mental health: integrating behavioural medicine into clinical psychology’, Annual Review of Clinical Psychology, 8, pp. 545–576.

Deci, E.L. and Ryan, R.M. (2000) ‘The “what” and “why” of goal pursuits: human needs and the self-determination of behaviour’, Psychological Inquiry, 11(4), pp. 227–268.

Deslandes, A.C. (2014) ‘Exercise and mental health: What did we learn?’, Frontiers in Psychiatry, 5, Article 66.

Farb, N.A.S., Segal, Z.V. and Anderson, A.K. (2013) ‘Mindfulness meditation training alters cortical representations of interoceptive attention’, Social Cognitive and Affective Neuroscience, 8(1), pp. 15–26.

Grahn, D.A., Cao, V.H. and Heller, H.C. (2005) ‘Heat extraction through the palm of one hand improves aerobic exercise endurance in a hot environment’, Journal of Applied Physiology, 99(3), pp. 972–978.

Heller, H.C. (2010) ‘The physiology of heat exchange: glabrous skin and performance enhancement’, Stanford University Human Performance Laboratory White Paper, Stanford, CA.

Jacobson, E. (1938) Progressive Relaxation. Chicago: University of Chicago Press.

Kabat-Zinn, J. (2003) ‘Mindfulness-based interventions in context: past, present, and future’, Clinical Psychology: Science and Practice, 10(2), pp. 144–156.

Koch, S.C., Riege, R.F., Tisborn, K., Biondo, J., Martin, L. and Beelmann, A. (2019) ‘Effects of dance movement therapy and dance on health-related psychological outcomes: A meta-analysis update’, Frontiers in Psychology, 10, Article 1806.

Li, F., Harmer, P., Fitzgerald, K. and Eckstrom, E. (2012) ‘Tai Chi and postural stability in patients with Parkinson’s disease’, New England Journal of Medicine, 366(6), pp. 511–519.

Mahindru, A. (2023) ‘Role of Physical Activity on Mental Health and Well-Being’, Frontiers in Psychiatry, Article 9902068.

Linehan, M.M. (2014) DBT Skills Training Manual. 2nd edn. New York: Guilford Press.

Mennitti, C., Che-Nordin, N., Meah, M.R., Poole, J.G. and González-Alonso, J. (2024) ‘How Does Physical Activity Modulate Hormone Responses?’, Biomolecules, 14(11), p. 1418.

Mirea, D. (2023) NeuroAffective-CBT®: ‘Tired, Exercise and Diet Your Way Out of Trouble: TED is Your Best Friend!’. NeuroAffective-CBT®. Available at: https://neuroaffectivecbt.com/2023/07/18/teds-your-best-friend/ [Accessed: 30 October 2025].

Mirea, D. (2025) NeuroAffective-CBT®: NeuroAffective-CBT®: Advancing the Frontiers of Cognitive-Behavioural Therapy. London: NeuroAffective-CBT® [Accessed 30 October 2025]

Nieman, D.C. (2018) ‘The compelling link between physical activity and the body’s defence system’, British Journal of Sports Medicine, 52(13), pp. 789–790.

Ratey, J.J. and Loehr, J.E. (2011) ‘The positive impact of physical activity on cognition and brain function’, Journal of Applied Sport Psychology, 23(4), pp. 373–394.

Salmon, P. (2001) ‘Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory’, Clinical Psychology Review, 21(1), pp. 33–61.

Schulz, S.M. (2016) ‘Neural correlates of heart-focused interoception: implications for neurovisceral integration in emotion regulation’, Frontiers in Psychology, 7, Article 1119.

Segal, Z.V., Williams, J.M.G. and Teasdale, J.D. (2002) Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.

Strasser, B. (2015) ‘Role of physical activity and diet on mood, behaviour, and cognition’, Neuroscience & Biobehavioural Reviews, 57, pp. 107–123.

Stonerock, G.L., Hoffman, B.M., Smith, P.J. and Blumenthal, J.A. (2015) ‘Exercise as treatment for anxiety: systematic review and analysis’, Annals of Behavioral Medicine, 49(4), pp. 542–556.

Teixeira, P.J., Carraça, E.V., Markland, D., Silva, M.N. and Ryan, R.M. (2012) ‘Exercise, physical activity, and self-determination theory: a systematic review’, International Journal of Behavioral Nutrition and Physical Activity, 9, Article 78.

Weinberg, R.S. and Gould, D. (2019) Foundations of Sport and Exercise Psychology. 8th edn. Champaign, IL: Human Kinetics.

World Health Organization (2020) Physical Activity Factsheet: Mental Health Benefits of Exercise. Geneva: WHO.

Further Reading & Clinical Resources

NeuroAffective-CBT® Framework:

• Mirea, D. (2025) NeuroAffective-CBT®: NeuroAffective-CBT®: Advancing the Frontiers of Cognitive-Behavioural Therapy. London: NeuroAffective-CBT® [Accessed 30/10/2025]
• Official website: https://neuroaffectivecbt.com

Exercise and Mental Health:

• Weinberg, R.S. and Gould, D. (2019) Foundations of Sport and Exercise Psychology. 8th edn. Champaign, IL: Human Kinetics.
• World Health Organization (2020) Physical Activity Factsheet: Mental Health Benefits of Exercise. Geneva: WHO.
• Harvard Medical School (2021) The Exercise Effect: How Physical Activity Boosts Mood and Mental Health. Cambridge, MA: Harvard Health Publishing.
• Ratey, J.J. (2008) Spark: The Revolutionary New Science of Exercise and the Brain. New York: Little, Brown and Company.

Relaxation and Mindfulness Practices:

• Kabat-Zinn, J. (2013) Full Catastrophe Living. New York: Bantam.
• Jacobson, E. (1938) Progressive Relaxation. Chicago: University of Chicago Press.

Therapeutic Integration:

• Beck, J.S. (2021) Cognitive Behavior Therapy: Basics and Beyond (3rd ed.). New York: Guilford Press.
• Linehan, M.M. (2015) DBT® Skills Training Manual. 2nd edn. New York: Guilford Press.
• Davis, M., Eshelman, E.R. and McKay, M. (2019) The Relaxation and Stress Reduction Workbook. 7th edn. Oakland, CA: New Harbinger Publications.


About the TED Series
The TED (Tired–Exercise–Diet) Series within NeuroAffective-CBT® explores the biological foundations of emotional regulation. Each instalment connects neuroscience, physiology, and cognitive-behavioural practice to create a unified framework for self-regulation, resilience, and psychological flexibility.
• Part I – Creatine and Cognitive Energy
• Part II – Insulin Resistance and Emotional Stability
• Part III – Omega-3 Fatty Acids and Neural Plasticity
• Part IV – Magnesium and Stress Recovery
• Part V – Vitamin C and Neuroprotection
• Part VI – Sleep and the Neurobiology of Fatigue (Tired)
• Part VII – Physical Exercise, Sports Science and Mental Health (Exercise)
• Part VIII (forthcoming) – Diet and the Biochemistry of Emotion

Glossary and Key Terms:

Behavioural activation is a CBT approach that helps people improve their mood by reconnecting with meaningful, goal-directed activities, especially when they feel low or unmotivated. When someone is depressed or anxious, they often withdraw from daily life and lose motivation, which makes them feel even worse. Behavioural activation works by re-introducing positive routines, encouraging gradual re-engagement in small, rewarding, or purposeful actions such as exercise, social contact, or creative tasks. In the TED framework, behavioural activation supports both the “Exercise” and “Diet” pillars by re-energising the body, increasing motivation, and helping to rebuild emotional stability through movement and engagement.

Circadian Rhythm
Your circadian rhythm is the body’s natural 24-hour internal clock that controls when you feel awake, sleepy, and even how your mood, hormones, and energy levels change throughout the day. It’s regulated mainly by light and darkness, sunlight in the morning tells your brain it’s time to be alert, while darkness at night signals that it’s time to rest. Keeping this rhythm regular (for example, by getting morning light, avoiding late-night screens, and sleeping at consistent times) helps improve sleep quality, mood, focus, and recovery.

Cognitive Corollary
A related mental or thinking process that accompanies a physical or biological change. For example, a cooler body temperature can make effort feel easier, improving focus and learning.

Cortisol
A natural hormone released by the adrenal glands, often called the “stress hormone.” It helps regulate metabolism, inflammation, and the body’s response to stress. Healthy cortisol levels rise in the morning to energise you and drop in the evening to help you rest.

HR (Heart Rate)
The number of times your heart beats per minute. Resting heart rate tends to be lower in fitter individuals and can rise with stress, dehydration, or illness.
HRV (Heart Rate Variability). A measure of the small variations in time between heartbeats. High HRV usually means your body can adapt well to stress; low HRV can indicate fatigue, overtraining, or poor recovery.

Hypertrophy Stimuli
Anything that triggers muscles to grow larger and stronger, such as resistance training, mechanical tension, or specific metabolic stress during exercise.

mTOR Repair Pathway
Short for “mechanistic Target of Rapamycin”, mTOR is a key biological pathway that helps the body grow and repair cells, especially muscle tissue. After exercise, this pathway acts like a “construction manager”, signalling the body to build new proteins, repair tiny muscle tears, and grow stronger tissue. If this process is interrupted for example, by too much cold exposure immediately after training, muscle recovery and growth can slow down.

Neuropathy
Damage or dysfunction of the nerves, often causing tingling, numbness, weakness, or pain, most commonly in the hands and feet. It can result from diabetes, injury, infections, or certain medications.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
A class of medications, such as ibuprofen, naproxen, and aspirin, used to reduce pain, inflammation, and fever. Overuse can sometimes irritate the stomach or affect kidney (renal) and liver (hepatic) function.

Protein synthesis – body’s process of building new proteins, which are essential for repairing tissues, producing hormones, and supporting growth and recovery, particularly after exercise. It’s how your muscles rebuild and strengthen following physical activity, and it also plays a role in brain health, helping support learning, memory, and mood regulation. This process depends on good nutrition, regular exercise, and adequate sleep, all of which are central to the TED model.
In essence, protein synthesis is the body’s repair and renewal system, keeping both mind and body in balance.

Raynaud’s / Vascular Disorders / Neuropathy
Conditions that alter blood flow or nerve function – consider when prescribing temperature strategies. Raynaud’s is a condition where blood vessels in the fingers and toes become overly sensitive to cold or stress, causing them to temporarily narrow. This limits blood flow and can make the skin turn white or blue and feel numb or painful.

Renal / Hepatic
“Renal” refers to the kidneys, which filter waste and maintain fluid balance. “Hepatic” refers to the liver, which processes nutrients, hormones, and drugs. Both organs are vital for detoxification and energy metabolism.

Tolerance – refers to the body’s process of adapting to a substance or stimulus over time, which makes its effects weaker or shorter-lasting.
For example, if someone regularly uses caffeine, certain medications, or motivational tools (like loud music or pre-workout stimulants), the body and brain gradually become less responsive to them. This means that more of the same stimulus is needed to achieve the same effect, or it stops working altogether.
In the context of the TED model, tolerance explains why “high-signal” tools, such as caffeine, nootropics, or intense motivation strategies, should be used sparingly, to prevent over-reliance and maintain natural motivation and balance.

TED Series, Part VI: Sleep and Mental Health – The Neuroscience of Restoration and Affective Regulation

Daniel Mirea (October 2025)
NeuroAffective-CBT® | https://neuroaffectivecbt.com

Abstract

In this sixth instalment of the TED (Tired–Exercise–Diet) Series, we explore the neuroscience of sleep and its central role in emotional regulation, cognitive function, and mental health. Sleep is not a passive state but a dynamic neurobiological process that restores metabolic balance, consolidates memory, and recalibrates affective and cognitive circuitry. Drawing on advances in neuroscience, psychoneuroendocrinology, and affective regulation, this article outlines how sleep deprivation disrupts the amygdala–prefrontal network, alters neurotransmitter systems, and amplifies emotional reactivity.

Within the NeuroAffective-CBT® (NA-CBT) framework, sleep represents the “T” in TED, the first pillar of biological stability upon which self-regulation and psychological flexibility depend. Practical guidance for integrating sleep education, circadian rhythm alignment, and behavioural sleep interventions into therapy is provided.


Introducing TED within the NA-CBT Framework

The TED model (Tired–Exercise–Diet) integrates neuroscience, psychophysiology, and behavioural science into a cohesive structure for promoting emotional regulation and biological stability. Within NeuroAffective-CBT®, TED forms the foundation of the Body–Brain–Affect triangle, a conceptual map linking physiology, cognition, and emotion (Mirea, 2023; Mirea, 2025).

Earlier instalments explored five key nutritional and metabolic regulators of mood and cognition: Creatine (Part I), Insulin Resistance (Part II), Omega-3 Fatty Acids (Part III), Magnesium (Part IV), and Vitamin C (Part V). This chapter returns to the first pillar, Tired, through the lens of sleep neuroscience, affect regulation, and therapeutic practice.


The Science of Sleep and Emotion

Sleep is a biological necessity, not a luxury. Across more than three decades of research, no psychiatric disorder has been identified in which sleep patterns remain normal (Walker, 2017). Disturbed sleep is both a symptom and a cause of emotional dysregulation, stress vulnerability, and cognitive decline.

A landmark neuroimaging study at the University of California, Berkeley, demonstrated that a single night of sleep deprivation increased amygdala reactivity to negative stimuli by 60% (Yoo et al., 2007). Functional connectivity between the amygdala and the medial prefrontal cortex, the brain’s emotional “brake system”, was significantly weakened. Without restorative sleep, emotional responses become amplified and poorly regulated.

Figure 1. The Emotional Brake System
Healthy sleep strengthens communication between the prefrontal cortex (rational control) and the amygdala (emotional response hub). When sleep is lost, this link weakens, leading to impulsivity and emotional hypersensitivity.

The TED Connection

  • T – Tired: Adequate sleep keeps the emotional “brake system” intact, balancing reactivity with control.
  • E – Exercise: Physical activity enhances sleep quality and increases prefrontal resilience, improving mood regulation.
  • D – Diet: Nutrients like magnesium, omega-3s, and vitamin C support neurotransmission and reduce the stress load on emotional circuits.

Together, sleep, movement, and nourishment maintain the brain’s emotional thermostat, preventing small frustrations from turning into major stress responses.


💡TED Translation: Sleep loss disconnects the brain’s emotional accelerator (the amygdala) from its brakes (the prefrontal cortex). When you’re tired, everyday irritations feel bigger and harder to control. Rest, movement, and balanced nutrition keep your emotional “engine” cool and responsive instead of overheated.


The Circadian Code and Homeostasis

Sleep is governed by two intertwined biological systems that keep the brain and body in rhythmic balance:

  1. The homeostatic drive – the longer you stay awake, the greater the pressure to sleep.
  2. The circadian rhythm – a 24-hour internal clock, regulated by the suprachiasmatic nucleus (SCN), which aligns your sleep–wake cycles with light and darkness.

When these systems are in sync, the brain functions like a finely tuned orchestra, hormones, temperature, energy, and mood all moving in harmony.
But when artificial light, screens, caffeine, or late-night work override these signals, the rhythm becomes distorted. This mismatch between the body’s internal clock and external demands, known as social jet lag, contributes to fatigue, mood disorders, metabolic changes, and stress dysregulation (Wittmann et al., 2006).


The TED Connection

  • T – Tired: Regular sleep and wake times reinforce circadian rhythm and stabilise mood.
  • E – Exercise: Morning or daytime movement strengthens the body’s clock by synchronising temperature, cortisol, and energy cycles.
  • D – Diet: Eating at consistent times and reducing caffeine or heavy meals in the evening helps align metabolic rhythms with the sleep–wake cycle.

When the TED systems are synchronised, the brain maintains homeostasis, a steady state where energy, hormones, and emotions work together in balance.


💡TED Translation: Your sleep–wake system is like a perfectly timed orchestra. Late nights, bright lights, and random meal times throw the conductor off beat, leading to brain fog, irritability, and poor mood regulation. Keep your rhythm steady with consistent sleep, movement, and mealtimes, and your body will play in tune again.


Sleep and Neurotransmitters

Sleep is among the body’s most powerful regulators of neurochemistry. When we lose sleep, the delicate balance of neurotransmitters that govern mood, motivation, and stress becomes disrupted.

  • Serotonin synthesis declines, reducing mood stability and impulse control.
  • Dopamine signalling becomes erratic, impairing motivation, pleasure, and focus.
  • Cortisol levels rise, keeping the body in a state of chronic alertness.
  • GABAergic tone drops, making it harder to relax and fall asleep.

Over time, this imbalance erodes emotional resilience and cognitive clarity. By contrast, adequate and regular sleep restores monoaminergic balance, recalibrates stress hormones, and strengthens the brain’s emotional regulation systems (Goldstein & Walker, 2014).


The TED Connection

  • T – Tired: Consistent, restorative sleep keeps neurotransmitters like serotonin, dopamine, and GABA in harmony — your brain’s emotional “chemistry set.”
  • E – Exercise: Regular movement boosts dopamine and endorphins, reinforcing motivation and supporting healthy sleep–wake cycles.
  • D – Diet: Nutrient-rich foods (omega-3s, magnesium, tryptophan, and B-vitamins) provide the raw materials for neurotransmitter production and recovery.

Together, sleep, movement, and nutrition maintain the neurochemical rhythm that underlies focus, motivation, and mood stability.


💡 TED Translation: When you skip sleep, your brain’s chemistry falls out of tune, more stress, less calm, less focus. Rest, movement, and nourishment reset the brain’s chemical harmony, helping you feel balanced, motivated, and emotionally steady again.


The Immune–Inflammatory Connection

Even partial sleep loss triggers the body’s immune defences as if it were responding to infection. Levels of inflammatory molecules such as interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) rise, disrupting normal immune balance and leaving the system in a state of chronic, low-grade activation (Irwin & Opp, 2017).

This silent inflammation interferes with neurotransmitters like serotonin and dopamine, fuelling fatigue, irritability, anxiety, and low mood. Over time, a vicious cycle develops: poor sleep increases inflammation, and inflammation in turn further disrupts sleep and emotional regulation.

The TED Connection

  • T – Tired: Adequate sleep lowers inflammatory markers, restoring immune and emotional balance.
  • E – Exercise: Moderate physical activity reduces systemic inflammation and improves immune resilience.
  • D – Diet: Anti-inflammatory foods (omega-3s, magnesium, vitamin C) help counter the stress effects of sleep loss. Alcohol is a highly addictive sedative and a psychological trap, as it convincingly mimics a relaxed state while actually disrupting natural sleep cycles. In contrast, many carbonated (fizzy) drinks act as stimulants, high in glucose and caffeine, which inevitably interfere with restorative sleep.

Together, the TED trio regulates the immune–inflammatory loop, protecting the brain and body from the emotional “wear and tear” of chronic stress and exhaustion.

💡TED Translation: When you don’t sleep enough, your body behaves like it’s under attack. This ongoing silent inflammation drains energy, darkens mood, and keeps your stress system switched on. Rest, movement, and nourishment are your body’s built-in anti-inflammatory medicine.


Sleep, Memory, and Emotional Learning

During REM sleep (Rapid Eye Movement sleep), the brain processes emotional experiences and consolidates learning without reigniting stress responses (van der Helm et al., 2011). This stage of sleep acts as an internal form of overnight therapy, allowing emotional memories to be reactivated, reorganised, and integrated in a calmer physiological state.

Within NeuroAffective-CBT®, this process is vital: therapeutic insights require offline consolidation to transform intellectual understanding into embodied, automatic regulation. In essence, sleep literally “files away” the day’s therapy work, embedding emotional learning into long-term stability.

💡TED Translation: Sleep is therapy’s silent partner. It helps your brain store emotional lessons without reawakening the stress attached to them.
REM sleep is your brain’s emotional reset stage, dream time when the mind replays feelings with the stress dialled down. Think of it as your overnight therapist, quietly helping you process the day, keep the wisdom, and release the worry so you wake up clearer and lighter.

Clinical and TED Practical Guidance

Improving sleep quality is less about effort and more about rhythm, aligning body, brain, and behaviour with the natural cycles that promote restoration. Within the TED framework, each pillar contributes to emotional stability and cognitive resilience through sleep regulation.

T – Tired: Sleep Hygiene and Restorative Rhythm

  • Aim for 7–9 hours of sleep each night, ideally aligned with natural darkness (around 10 p.m.–6 a.m.).
  • Keep a consistent sleep–wake schedule, even on weekends, to stabilise your internal clock.
  • Create a sleep-supportive environment: cool, dark, and quiet spaces enhance deep sleep quality.
  • Practice digital hygiene: avoid screens, bright light, and stimulating activities 60–90 minutes before bed to allow melatonin release.

E – Exercise: Movement as a Sleep Stabiliser

  • Engage in regular physical activity, ideally during daylight hours, to promote circadian alignment.
  • Gentle evening movement such as stretching, yoga or progressive muscle relaxation, can calm the nervous system.
  • Avoid vigorous exercise within two hours of bedtime, as it may elevate arousal and delay sleep onset.
  • Movement also improves slow-wave sleep, supporting memory consolidation and emotional regulation.

D – Diet: Nutritional Support for Rest and Recovery

  • Avoid heavy meals, caffeine, or alcohol within three to four hours of bedtime.
  • Prioritise nutrient-rich foods that support neurotransmitter balance: magnesium, tryptophan, omega-3 fatty acids, and vitamin C.
  • Maintain consistent meal timing, as irregular eating can disturb circadian rhythm and sleep quality.
  • Hydrate well during the day, but reduce fluid intake in the evening to prevent sleep disruption.

Therapeutic Integration

In clinical practice, these habits can be reinforced through cognitive and behavioural interventions for insomnia; techniques such as stimulus control, sleep scheduling, and relaxation training. Within NA-CBT, these methods are integrated with affect regulation, somatic grounding, psychoeducation, and personalised lifestyle adjustments that help clients synchronise biological and emotional rhythms.


💡TED Translation: Good sleep isn’t about trying harder, it’s about working with your body’s natural rhythm. Keep nights dark, meals early, and habits steady. Move during the day, rest at night, and eat in rhythm and your emotional brain will do the rest.


Summary and Outlook

Sleep represents the biological foundation of the TED model; the “T” in Tired, Exercise, Diet. It is the first and most essential pillar supporting affect regulation, learning, and resilience. Within NA-CBT, sleep is viewed as a biopsychological regulator shaping the efficiency of all subsequent therapeutic and behavioural change.

Future TED work should examine how sleep interacts with diet (glycaemic balance, magnesium, vitamin C) and exercise (circadian entrainment, fatigue management), integrating these findings into structured protocols for mood and stress disorders.


Glossary

Amygdala–Prefrontal Network
A key emotional regulation circuit linking the amygdala (the brain’s emotional response centre) and the prefrontal cortex (responsible for rational control and decision-making). Healthy sleep strengthens communication within this network, promoting balanced emotional responses.

Circadian Rhythm
The body’s internal 24-hour biological clock that regulates sleep–wake cycles, hormone release, temperature, and energy levels. It is governed by the suprachiasmatic nucleus (SCN) and synchronised by environmental cues such as light, activity, and mealtimes.

Homeostatic Sleep Drive
The internal biological pressure to sleep that increases the longer one stays awake. Sleep dissipates this pressure, maintaining equilibrium between rest and wakefulness.

NeuroAffective-CBT® (NA-CBT)
A therapeutic framework developed by Daniel Mirea that integrates neuroscience, affect regulation, and cognitive–behavioural methods. It emphasises aligning biological, cognitive, and emotional systems to enhance self-regulation and psychological flexibility.

Progressive Muscle Relaxation (PMR)
A structured relaxation technique that involves tensing and releasing muscle groups throughout the body to reduce physical tension and activate the parasympathetic nervous system. PMR is commonly used to ease anxiety and prepare the body for sleep.

Rapid Eye Movement (REM) Sleep
A distinct phase of the sleep cycle marked by vivid dreaming, rapid eye movements, and heightened brain activity. REM sleep supports emotional processing, memory consolidation, and the integration of affective experiences.

Relaxation Training
A collection of techniques such as, slow breathing, mindfulness, guided imagery, and PMR, designed to reduce physiological arousal and promote calm. Relaxation training activates the body’s “rest-and-digest” system, improving stress recovery and sleep quality.

Sleep Hygiene
A set of behavioural and environmental practices that promote healthy sleep. Core principles include maintaining a consistent sleep–wake schedule, creating a dark and quiet sleep environment, avoiding stimulants before bedtime, and limiting screen exposure in the evening.

Sleep Scheduling
A behavioural intervention for regulating circadian rhythm and improving sleep efficiency. It involves setting fixed bedtimes and wake times, aligning sleep duration with actual sleep need, and gradually adjusting these times to consolidate sleep.

Social Jet Lag
The misalignment between the body’s internal clock and social or work schedules. It commonly arises from late nights, weekend sleep shifts, or irregular meal and activity times, leading to fatigue, mood changes, and metabolic disruption.

Stimulus Control
A behavioural therapy principle aimed at strengthening the association between bed and sleep. It includes going to bed only when sleepy, using the bed solely for sleep and intimacy, rising at the same time daily, and avoiding wakeful activities in bed.

T E D Model (Tired–Exercise–Diet)
An integrative framework within NeuroAffective-CBT® (the third module out of six) linking biological stability with emotional regulation. The model emphasises three foundational pillars, sleep (Tired), movement (Exercise), and nutrition (Diet), as interdependent systems supporting mental health and resilience.

References

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Goldstein A.N. & Walker M.P., 2014. The role of sleep in emotional brain function. Annual Review of Clinical Psychology, 10, pp.679–708.

Ingram R.E. & Siegle G.J., 2009. Contemporary Issues in Cognitive Therapy. New York: Springer.

Irwin M.R. & Opp M.R., 2017. Sleep health: Reciprocal regulation of sleep and innate immunity. Neuropsychopharmacology, 42(1), pp.129–155.

Mirea D., 2023. Tired, Exercise and Diet Your Way Out of Trouble (TED Model). NeuroAffective-CBT®. Available at: https://neuroaffectivecbt.com [Accessed 27 October 2025].

Mirea D., 2025. TED Series, Part VI: Sleep and Mental Health – The Neuroscience of Restoration and Emotional Regulation. NeuroAffective-CBT®. Available at: https://neuroaffectivecbt.com [Accessed 27 October 2025].

Segal Z.V., Teasdale J.D. & Williams J.M.G., 2018. Mindfulness-Based Cognitive Therapy for Depression. 2nd ed. New York: Guilford Press.

van der Helm E et al., 2011. REM sleep depotentiates amygdala activity to previous emotional experiences. Current Biology, 21(23), pp.2029–2032.

Thayer, J.F. and Lane, R.D., 2000. A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61(3), pp.201–216.

Walker M.P., 2017. Why We Sleep: Unlocking the Power of Sleep and Dreams. London: Penguin Press.

Wells A., 2009. Metacognitive Therapy for Anxiety and Depression. New York: Guilford Press.

Wittmann M et al., 2006. Social jetlag: Misalignment of biological and social time. Chronobiology International, 23(1–2), pp.497–509.

Yoo S.S. et al., 2007. The human emotional brain without sleep – a prefrontal amygdala disconnect. Current Biology, 17(20), pp.R877–R878.


Disclaimer

This article is for educational purposes only and is not a substitute for medical or psychological assessment. Individuals experiencing chronic insomnia or mood disturbances should consult a GP, sleep specialist, or licensed psychotherapist before implementing new interventions.