Women in modern society are busy. We are individuals, mothers, wives, professionals, volunteers and friends. We over-schedule and over-extend, leading to lives consumed by stress. Stress can take a toll on our bodies and we often wear it physically in the form of medical illness. That’s right: stress can make you sick.
Acute stress is a normal and essential physiologic response. It is often referred to as the “fight or flight response”. Imagine yourself walking through your yard and coming across an alligator. You perceive danger and your nervous system gets ready for action. Your heart starts to beat faster, breathing quickens, digestion slows and stress hormones are released in preparation for conflict. This is an appropriate response when faced with a dangerous situation.
In chronic stress, however, our bodies live in a perpetual state of “fight or flight” by perceiving danger that is not present. Similarly to driving your car full throttle all the time, eventually your parts will wear out. Living with chronic stress has detrimental health effects. Research has suggested that women living with high levels of stress age faster. Chronic stress has been linked to numerous medical problems, including heart disease, high blood pressure, autoimmune disorders, anxiety, depression, irritable bowel syndrome and even infertility. It has been estimated that 60-90% of doctor visits are for stress-related issues. Conventional medicine is very good at managing many of these chronic illnesses, but there is more that we can do for treatment and prevention.
Mind Body Medicine focuses on using the mind to influence physical health. Does that sound strange or alternative to you? It shouldn’t. We unknowingly use Mind Body techniques frequently. Do you ever take a deep breath in a stressful situation to center yourself? Do you exercise for stress relief? Do you pray when you are worried? If so, then you are already using Mind Body modalities. Dr. Herbert Benson, the founder of the Benson-Henry Institute for Mind Body Medicine at Harvard, described medicine ideally as a three-legged stool, balanced equally by medicines, surgery, and self-care approaches. He is responsible for describing the Relaxation Response, the response opposite to the stress (“fight or flight”) response. His scientific research has shown that regular elicitation of the Relaxation Response can prevent and reverse some of the damage done by chronic stress. There are many ways in which we can evoke the Relaxation Response, including breathwork, biofeedback, guided imagery, prayer, yoga, meditation and mindfulness. The Relaxation Response can even be generated from activities such as painting, knitting or physical exercise.
Breathwork is an easy place to start to explore Mind Body Medicine. Breathing is one of the few bodily functions over which we have both voluntary and involuntary control, meaning that we can make ourselves do it but we also do it without any thought or effort. By using the breath, we can affect our physiology and help to manage stress. A simple breathing exercise known as the 4-7-8 breath was developed by Dr. Andrew Weil, a pioneer and leader in the field of Integrative Medicine. Done twice a day with four repetitions each time, the 4-7-8 breathing technique is an easy and fast exercise to incorporate into your daily life that has the potential to promote relaxation and relieve stress. It can even help you fall asleep at night. Here is how to do it: Find a comfortable place to sit with your back straight, place your tongue against the ridge behind your front teeth, close your mouth, inhale through the nose for a count of four, hold your breath for a count of seven and exhale through your mouth for a count of eight. Repeat three more times. Although twice daily practice is most beneficial, the 4-7-8 can also be done any time you feel it may be helpful.
Meditation is another modality to consider making part of your daily routine. Meditation is defined by the National Center for Complementary and Integrative Health as “a mind and body practice that has a long history of use for increasing calmness and physical relaxation, improving psychological balance, coping with illness, and enhancing overall health and well-being.” Many people may perceive meditation to be a strange and foreign practice, but it actually requires no particular religion or cultural beliefs. I often hear people resist meditation, saying that they cannot shut off their minds or be still. The good news is that meditation is not about stopping your thoughts but about redirecting them. It is not about zoning out, but rather zoning in. Scientific studies have shown that meditation may be beneficial in conditions such as headache, high blood pressure, chronic pain, irritable bowel syndrome, smoking cessation, anxiety and depression. It may even be helpful in reducing menopausal symptoms and regulating the immune system. In 1998, Dr. Jon Kabat-Zinn, the founding Executive Director of the Center for Mindfulness in Medicine at the University of Massachusetts Medical School, conducted a research study looking at the effect of meditation on psoriasis. Psoriasis is a common autoimmune skin condition that results in patches of scaly skin. Patients with psoriasis undergoing ultraviolet phototherapy either received UV light therapy alone or while listening to a guided meditation during the treatment. Dr. Kabat-Zinn found that the patients who meditated had more rapid clearing of the psoriasis. This study demonstrated the powerful effect that meditation can have on healing.
Because we live our lives busily and frantically, we are often not truly aware of the present moment. Mindfulness is an old tradition that has gained popularity in recent years. It is a way of training the mind to be fully present. Dr. Kabat-Zinn defines mindfulness as “paying attention in a particular way; on purpose, in the present moment, and nonjudgementally.” In addition to a daily meditative practice, mindfulness is weaved into everyday activities by focusing in the present moment with a kind and open mind. Imaging techniques have shown that “happy” areas of the brain light up with mindfulness meditation. Mindfulness has been studied as a compliment to conventional care for numerous medical conditions, including anxiety, stress disorders, asthma, chronic pain, heart disease, hypertension, and gastrointestinal disorders. If you are curious about meditation and mindfulness, the Center for Mindfulness at the University of Massachusetts is a good resource, particularly the Mindfulness-Based Stress Reduction Program. Headspace, a mobile app and website, is a great place to help you get started with a daily mindfulness meditation practice.
Relaxation techniques are many. As with any medical intervention, one size does not fit all. What is important is that we recognize the stress in our lives and have the foresight to intervene for the sake of our health and general wellbeing. Learning to truly relax and be present can not only assist in treating existing medical illness but may prevent future disease. Am I suggesting that you throw your medicine in the trash, cancel your surgery, buy a meditation pillow and get to work? Absolutely not. I am suggesting that, in addition to conventional therapies, we unleash the healing power of our minds and intentionally incorporate the Relaxation Response into our daily life.
Last year, I was fortunate to be present for a lecture given by Dr. Shauna Shapiro, a psychologist and expert in Mindfulness. She made a profound statement that has stuck with me ever since: “what we practice becomes stronger”. This is true for both the negative and the positive. If we practice impatience and anger and anxiety, they will become stronger in our lives. If we practice peaceand patience and positivity, they will become stronger. Which will you choose?
Dr. Nicole Cotter is a rheumatologist currently practicing medicine in Shreveport, Louisiana. She is board certified in Rheumatology and Internal Medicine and is studying Integrative Medicine through the Arizona Center for Integrative Medicine. Dr. Cotter believes that an integrative approach to health is ideal. When not in clinic, you can find her reading, running, cooking with her husband or chasing her two kids.