Being rich and famous doesn’t inoculate you from serious health woes. This became clear during Gaga’s revealing hour-long interview with Winfrey in Fort Lauderdale, Florida, at the first of Winfrey’s 2020 wellness tour. Winfrey is traveling to nine U.S. cities to hold rallies sponsored by WW (the new name for Weight Watchers as it expands beyond weight loss and into wellness). Gaga, whose real name is Stefani Germanotta, said that inventing the persona of Lady Gaga was a way “to create a superhero for myself” who was confident and secure at a time Germanotta, who had been bullied as a teen, was not, she told the 15,000 arena attendees. Gaga hasn’t been shy about revealing her mental conditions. At least in part from being sexually assaulted multiple times at age 19, she suffers from post-traumatic stress disorder (PTSD) and “head to toe” chronic pain from fibromyalgia. She confessed that she used to cut herself, and she once suffered a complete psychotic break that required hospitalization. All of this inspired her to create an organization dedicated to mental health, called the Born This Way Foundation. RELATED: 11 Celebrities Who Have Spoken Out About Sexual Assault

1. She Practices Transcendental Meditation (TM) to Manage Chronic Pain

TM is a type of meditation performed while sitting in a comfortable position, where you focus your mind on a silently repeated mantra. Each mantra is individualized for a specific person, which is given by a certified TM instructor as part of a class, according to TM.org. “TM is amazing,” Gaga said. “Sometimes I can be in a ton of pain and meditate, and it goes away.” Studies have shown that, like other meditation techniques, TM decreases anxiety. Employees subject to burnout who were introduced to TM, for example, felt less stressed, depressed, or depleted than a control group, according to a randomized controlled study published in the winter 2014 issue of Permanente Journal.

2. When She Is Physically Able, She Exercises to Reduce Stress

For someone whose career involves dancing on stage, it’s not surprising that Gaga aims to work out daily. But, she asserted, “I also listen to my body. If I’m in a lot of pain and deep stress, I might not do as hard of a workout, or I might not work out at all.” Avigdor Arad, PhD, the director of the Mount Sinai PhysioLab, a nutrition and exercise physiology clinic in New York City, says not overdoing a workout when your body truly isn’t up to it is a good thing. But while he appreciates that an incredible athlete like Gaga respects her limits, he cautions the average person not to use this as an excuse to avoid the gym. “You have to ask yourself why you don’t want to exercise today. Is it that you really have a physical pain that limits you, or do you just not feel like it?” he says. If on a planned workout day you simply can’t gin up much effort, he suggests you still find some way to move your body. “If you had a rough day or you slept poorly, maybe it’s not the time to run 10K.” But you can do something else, like gentle stretching, yoga, swimming, tai chi, or walking, he says. RELATED: 10 Amazing Benefits of Exercise

3. To Learn and Grow, She Practices Gratitude

Both Gaga and Oprah sing the praises of appreciation. Thinking about things you are thankful for is a great way to help you feel good, they said. For Gaga, finding the sense of gratitude has no limits. She practices even while experiencing severe pain, she said. “I will be lying on my porch crying. And I will say, ‘Thank you, God, for this pain. This pain is meant for me and my body right now. I’m here in this moment. And I’m learning. Thank you for teaching me.’”

4. She Leans on Friends to Help Relieve Depressive Symptoms

Gaga’s friends and employees (whom she also calls her friends) provide an important source of support. Sometimes she’ll call a friend to go out or play a game of poker when she’s depressed and would much prefer to stay home, a process she calls “opposite action” that keeps her from sinking into a deeper state. Her friends help in whatever ways she needs. “If you think someone is bringing me caviar all day, they’re more likely to be giving me a bowl of ice to dunk my head so I don’t have a dissociative state,” she said. Dawn Mussallem, DO, a family physician at the Mayo Clinic in Jacksonville, Florida, who specializes in helping people with cancer boost their lifestyle, says leaning on friends is a terrific wellness strategy. “We see with cancer patients and others that friends, family, church, or support groups are profoundly important for mental health and overall wellness,” she says. RELATED: 10 Ways to Boost Your Emotional Health

5. To Manage Her Mental Health, She Does Dialectical Behavioral Therapy (DBT)

Similar to the better known cognitive behavioral therapy (CBT), DBT was developed to deal with severe mental-health conditions, including attempted suicide, according to past research. In DBT, clients learn about the triggers that lead to their reactive states and learn coping skills to avoid a mental cascade. Explaining how DBT works for her, Gaga says: “If I’m upset, I’ll ask why I am upset. I will write down all the reasons, and then I will check the facts. Then I’ll go to the next stage and ask what action am I going to take now to solve the problem.” For example, if she is sad because her body is in pain, she might decide to reach out to a friend or call her doctor. In some instances, baby steps are all the actions she can muster, and that’s fine. If she doesn’t feel well, she might make herself take a bath, get dressed, and brush her hair rather than lounge around. “This is something you learn in DBT: You’ve got to keep moving,” an act she says is called “throwing yourself into the moment.” DBT has been found to be helpful in research. A review published in January 2019 in Behavior Therapy of patients exhibiting self-harm or suicidal behavior found it reduced self-directed violence and the frequency of needed psychiatric crisis care.

6. As an Act of Rebellion, She Treats Others With Kindness

In addition to gratitude, another key spiritual practice for Gaga is kindness. “Kindness heals the world” by bringing us together, and it is also a way to keep us healthy, she says, so she practices kindness regularly. In fact, in a November 2019 Elle article, Gaga called herself a “kindness punk.” “Punks have a reputation for being rebellious. For me, I view my career as a rebellion against all the things in the world that I see to be unkind,” she says in the article. RELATED: 6 Ways Spirituality Can Help Make You Healthier

7. She Takes Medication to Help Treat Her Mental Health Conditions

Mental-health problems are medical conditions and should be treated the same way physical ailments are, Gaga said. “I think a lot of people are afraid of medicine for their brains to help them. And I really want to just erase the stigma around this,” she said. After her psychotic breakdown, Gaga began taking various pharmaceuticals, including an antipsychotic and a muscle relaxant. These pills “saved my life,” she said. But she emphasizes that “what I take is not necessarily what you need to take.” Gaga emphasized that psychiatric drugs, including antidepressants, should be prescribed by a psychiatrist whenever possible. Dr. Mussallem agrees. When you see a psychiatrist, you are properly assessed for what you actually need, she says. People go to their general practitioner to get the fast-fix of an antidepressant, but maybe cognitive behavioral therapy (CBT) would be a better approach, she says. As a family physician, “I myself fear starting a patient on a medication that really doesn’t fix the problem and might even make things worse,” she admits. “When it comes to mental-health diseases, trained mental-health professionals need to be involved.” RELATED: Celebrities Living With Rheumatic Diseases You can watch the full interview with Lady Gaga from Oprah’s 2020 Vision Tour on the WW website. Interviews with other outspoken celebrities, including Jennifer Lopez, Michelle Obama, Tina Fey, and more will be posted as the tour continues.