Tag: Stress

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Health

The argument for doing “nothing”…

Do you remember being a kid, and having nothing to do for hours? Whole summer afternoons that seemed to last forever, just lazing around, being bored, thinking and daydreaming?

And, now that we’re adults, we make our lists, try to be as productive as possible, and want to squeeze as much “doing” in as we can.

But when is our time to think? If you’re a Big Bang Theory fan you may remember the episode with Amy, reading then just staring blankly off into the distance… When asked if she was OK, she answered: “Yes. I was reading. And now I’m thinking about what I read.” Sometimes we need time to just think, to figure out what to do with all that information coming at us.

Our brains work on several levels to process information. You may have noticed that something you were trying to remember will just pop into your head later when doing something completely unrelated. Especially when engaged in an activity that doesn’t require deep concentration, your subconscious will continue to work on solving a problem even though you weren’t actively trying.

And, even if it doesn’t find the solution for you, you’ll see the problem with fresh eyes and more energy when you return to it. Writers often use this technique to improve their ability to see writing problems – we walk away, take a break from our work, and magically can see lots we can improve when we return. I’m sure this process can work for many tasks and makes a strong case for taking regular breaks from any lengthy project.

The other problems we can have from constant “busyness” with little time to think are fatigue, stress and burn-out. But taking a break from work and spending it reading our devices isn’t really a break for our mind. A really helpful break is more like what Amy was doing: staring off into space. Closing eyes and listening to music or meditating give a similar effect. The Dutch call this “niksen” – doing nothing.

Taking short but regular “niksen” breaks during the day, even if it’s just a few minutes to relax and take a few deep breaths, can help you to be more productive when you return to work at the same time as it’s preventing overload, stress and burnout. Any sort of breathing exercise can help by distracting, giving you something else to concentrate on – I often used this technique to distract patients before giving them their flu shot. It worked well, giving the person something else to focus on besides the needle I had in my hand. Studies say distraction actually lessens the pain experienced during an injection.

Now, I’ve never been able to sit still and meditate without getting antsy, but I have found repetitive activities like knitting or jigsaw puzzles seem to fit the bill, occupying the mind and giving it a break from being busy. The key is creating a break for your mind, letting it wander and giving it time to process.

So, make time to be bored (or at least to do something mindless) on a regular basis – your brain will likely thank you for it!

And, if it’s time to give your brain a break and just do nothing, here’s a link to “The Nothing Song”

Read more here:

The Case for Doing Nothing – The New York Times

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Health

Dance away your cares!

Saturday, July 1st, is Canada’s 150th birthday, and there will be music and celebration across the country… and, no doubt, lots of dancing, singing and just plain happiness! Celebrations are good for the spirit and dancing is one of the most fun types of exercise.

Dancing can actually be used as a therapy for many conditions, including anxiety, depression, feelings of isolation and chronic pain. It’s also used in patients with brain injury, AIDS, arthritis, autism, cancer and other conditions. It can be performed by those who are physically disabled, mentally handicapped and even elderly folks in nursing homes. Last week, I watched a video of a group of ladies dancing with their walkers to “Rock around the clock” – they were having a wonderful time! Click here to enjoy it too!

Dance therapy works for anxiety, depression and pain through the mind/body connection. In addition to the exercise component and exposure to music – both therapeutic in themselves – dance allows expression of feelings and thoughts through movement. And it’s fun!

A trained dance therapist can see dance movements as a source of information… an expression of the client’s subconscious thoughts and emotions, relationships to others, and symbolic movements that are personal to each individual. Feedback to the client from the therapist is used to promote increased self-awareness. Changing movements is claimed to initiate a change in the subconscious, and vice versa. So, trying out a new dance or changing up your moves can be even more uplifting. Dance is thought to express something that cannot be expressed in any other way.

Regardless of the interpretations a trained dance therapist can extract, there is no doubt dancing is therapeutic, even without anyone analyzing your movements! Moving to music you love is great exercise and lots of fun, and guaranteed to lift your spirits. It’s an exercise you can do while socializing with a group: formally at a class, informally at a club, or at a family wedding… or all by yourself with music blaring while cleaning the kitchen! Dancing with your kids or grandchildren is especially fun. A favourite activity in our house was dancing to the music of Dire Straits on a Saturday morning…some of their tunes still make me want to get up and dance!

So, turn up the music and dance like nobody’s watching… as often as you can… no matter who is around! It will improve your fitness level and lift your spirits, and might even help reduce anxiety, depression and pain.

Happy Canada Day!

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Health

Stressed? Try the Relaxation Response

The Relaxation Response essentially functions as the opposite of the Stress Response. Stress increases heart rate, and blood pressure – which increase risk of heart disease and stroke – as well as breathing rate and rate of body metabolism. The Relaxation Response does the opposite, and has been proposed as a method of reducing the physical effects of stress and decreasing anxiety.

These are the 4 steps to induce the Relaxation Response:

  1. Find a quiet environment – decrease outside distractions

  2. Focus on something – repeat a word or sound aloud or in your head, look at a symbol or just down at the ground, or concentrate on a particular feeling (love, happiness) to help eliminate outside thoughts

  3. Keep a passive attitude – empty thoughts from your mind; do not be concerned about how you are doing

  4. Sit in a comfortable position – you need to remain still for 10 – 20 minutes. You do not want to fall asleep. Note that these 4 elements will also aid in falling asleep if you are lying down.

It is recommended to practice this relaxation exercise for 10 to 20 minutes, twice a day. Some find the timing in relation to their day’s events can make a difference in their results – for example, inducing a relaxation response before bedtime can make it easier to fall asleep.

Many cultures and religious practices, even back in ancient times, include forms of exercise similar to this as a way to enlightenment, improvement in mood and happiness. The focus can be reciting a prayer for those who practice religion – the result is the same: slowed breathing, heart rate, and metabolism; reduced blood pressure; and improved mood. Yoga and transcendental meditation are two examples that are still widely practiced today.

In the distant past, the ability to respond to physical dangers was life saving…the “fight or flight” response that increased blood flow to limbs, increased heart rate and breathing, and increased blood pressure, set man up to fight off a wild animal or escape from it.

But modern life exposes us to many, much different sources of stress, few of which require a physical strength response. Changes in work, family or environment – especially rapid changes – require us to constantly adjust, triggering the same release of stress hormones. Loss of a loved one, especially a spouse, creates high levels of stress and even happy events, like a promotion, marriage or a new baby, induce a stress response. Simply living in the city versus a rural area is associated with higher stress, and uncertainty (think of world politics!) adds to stress too.

Studies have demonstrated that repeated transient surges of stress hormones eventually lead to a permanent increase in blood pressure, also known as “hypertension”. This provides a plausible explanation for the 90-95% of hypertension of unexplained cause, termed “essential hypertension”. Since increased blood pressure, is associated with increased risk of heart disease and stroke, practicing the Relaxation Response at least during times of increased stress may be a means to reduce the risk these diseases. While relaxation exercises are not a substitute for medication in moderate to severe hypertension, studies suggest they could add to the effect of medication, allowing lowered doses for control. Studies also suggest practicing the Relaxation Response could avoid development of the condition and be beneficial in controlling mild forms, along with other lifestyle changes.

However, few doctors ask about your levels of stress at a check up. Stress hormones naturally fluctuate widely during the day, generally being higher in the morning, peaking at each meal, and dropping lower at night – a good thing, as the effects of stress hormones keep you alert and awake, and ready for “fight or flight” – not what you want at bedtime! It seems likely that middle of the night awakening, where you’re tired but your mind is racing (described as “tired but wired”) may be caused by an inappropriate surge in production of stress hormones in the middle of the night.

Stress is most often treated within the realm of psychology and mental illness, with tranquilizers and antidepressants being prescribed when stress-induced anxiety becomes unbearable. However, learning to trigger the Relaxation Response to reduce the negative effects of stress is side effect-free and costs nothing to practice.

While family physicians receive little formal training in these techniques, many alternative medicine practitioners use meditation and relaxation techniques as part of their therapy. Integration of standard medical treatment and alternative medicine practices like these could result in better treatment for patients and minimization of medications, while reducing cost and decreasing the risk of negative side effects.

This relaxation technique is easy to learn – just follow the 4 steps above. Entering a full relaxation response with lowered blood pressure will become easier and more complete with practice, and can make a significant improvement in your health!

Reference: The Relaxation Response, by Herbert Benson MD

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Article reprint Health

Stress – The Elephant in the Room

Remember those predictions about working a four-day workweek in the new millenium? Well, it hasn’t worked out that way, has it! Computers and BlackBerrys, while making us more efficient, have also made us more accessible to work on evenings and weekends. Cutbacks often result in one person doing work that was previously assigned to several people. In my world, a lack of pharmacists often means long hours and less vacation time.

The result is increased stress—a contributing factor in many disease states that is rarely addressed in the course of a routine medical visit. Stress is listed as one of the modifiable causes of heart disease, and several of the effects of the stress hormone, cortisol, match up alarmingly with the symptoms of metabolic syndrome: increased blood pressure, weight gain around the waist, increased cholesterol and insulin resistance. Could it be that excess production of cortisol due to stress is that elusive cause of metabolic syndrome?

Researchers have observed that the appearance of cancer in many patients is preceded by a stressful event about two years earlier. Anyone who suffers from cold sores will tell you that they are most likely to show up when they are under stress. Emergency wards and student health centres note an increased demand for services during stressful times. Excessive production of cortisol is known to have a negative effect on the immune system, and the metabolic pathways by which this occurs have actually been identified. And stress hormones, being structurally similar to our reproductive hormones, can worsen the symptoms of menopause.

It’s enough to make you wonder why we don’t routinely test for and treat elevated cortisol blood levels…Perhaps it’s because physicians themselves have not been spared from the increased pace of life, and few are able to take time during an appointment to discuss the issues surrounding stress in a patient’s life.

Non-drug options for stress

Anti-depressants and tranquilizers are standard medications offered to highly stressed patients, but, as well as having high side effect profiles, they do not directly address the production of cortisol. However, in the herbal world, there are a number of medicines known as cortisol modifiers and adaptogens that lower cortisol production and lessen the impact of stress. As well, simple changes in lifestyle, attitudes and nutrition can result in a healthier response to the everyday stresses of life.

Those who really need help should be see a stress specialist. However, for those who are less severely stressed, I can pass along some self-help suggestions and recommend nonprescription supplements.

A good place to start is with a lifestyle assessment. Make a list of factors that are “good for me” versus “bad for me,” then devise a plan to relieve the worst factors, using a strategy to “change, adapt to, or leave” the most stressful situations. As stress hormones set up the body for “fight or flight,” exercise can be recommended to help reverse some of the effects of these hormones. Dietary recommendations to lower cortisol include eating balanced meals regularly throughout the day, ingesting a small amount of salt (sodium is required for adrenal function), avoiding simple sugars, increasing protein and essential fatty acids, and avoiding coffee, including decaffeinated (both contain theobromine, which tends to raise cortisol).

Substituting green tea for coffee, and vegetable juice for fruit juice is often advised. Vitamin C up to 3000 mg per day (either in divided doses or as a slow-release tablet) is recommended, as are B vitamins, particularly B5 or pantothenic acid, to support healthy adrenal function. Magnesium is a co-factor for many reactions that involve energy metabolism and nervous system function. Therefore the need for magnesium may be increased during periods of stress.

Magnesium is also necessary for muscle relaxation, and a deficiency increases the risk of muscle spasms that will often develop as a response to stress.

Herbal medications available for treating stress are divided into two major categories: the cortisol-modulating supplements (such as theanine, epimedium, and phytosterols) and the adaptogens or general anti-stress supplements (such as ginseng, schisandra, and astragalus). I will review some of the properties of some of these supplements to help distinguish which might be best for a particular client.

Cortisol modulating herbs

Theanine
Theanine is an amino acid. It acts as a non-sedating relaxant, helping to increase the brain’s production of alpha waves, one of the four basic brainwave patterns. Alpha wave production is associated with relaxed alertness, increased focus and concentration, promotion of creativity and improved overall mental performance. Theanine occurs naturally in tea leaves, and is converted by the plant gradually over time into catechins, the substance in tea known for its antioxidant benefits. Green tea, which is less aged than black tea, therefore contains more theanine than the other more aged varieties. As well, users should be aware that the decaffeination process removes theanine from tea along with the caffeine. Theanine has been shown in clinical studies to be effective in dosages from 50 to 200 mg per day. Three to four cups of green tea contain 100 to 200 mg of theanine. It is also available in supplement form.

Epimedium
Epimedium, also known as horny goat weed, has been shown to restore low levels of both testosterone and thyroid to normal levels, in addition to reducing cortisol levels when elevated. Hence, it has a reputation for improving libido in stressed individuals. Water-extracted epimedium, the traditional method of preparing this herb, is considered a safer form than the alcohol extract as rodent studies suggest that high doses of icariin, an alcohol-soluble constituent, may be associated with kidney and liver toxicity. A suggested dose for cortisol control is 250 to 1000 mg per day.

Phytosterols
Phytosterols include hundreds of plant-derived sterol compounds that are structurally similar to cholesterol but do not clog our arteries. By controlling production of inflammatory cytokines, phytosterols help modulate immune function, inflammation and pain levels. They have been shown to prevent immune system suppression and cortisol elevation usually seen in athletes after endurance events. Preliminary evidence from animal studies suggests that dietary phytosterols retard the growth and spread of breast cancer cells. Beta-sitosterol, one of the major phytosterols, has been shown in humans to normalize activity of T-helper lymphocytes and natural killer cells following stressful events that normally suppress immune system function. A typical dosage is 100 to 300 mg per day of mixed phytosterols, including 60 to 120 mg per day of beta-sitosterol. A handful of roasted peanuts or 2 tablespoons of peanut butter contain 10 to 30 mg of beta-sitosterol. Rice bran, corn, wheat germ and flaxseed are examples of rich food sources of phytosterols. See www.dietaryfiberfood.com for more information on the phytosterol content of foods.

Phosphatidylserine
Phosphatidylserine has been shown to modulate many aspects of cortisol overproduction, especially after intense exercise. There is scientific evidence that it can help improve mental function and depression, even in Alzheimer’s disease. Because cortisol causes catabolism of muscle tissue, athletes will frequently use this supplement to promote recovery from exercise and help slow muscle loss. Practitioners sometimes suggest phosphatidylserine supplements be taken late in the day to reduce nocturnal awakening due to surges in cortisol production during the night. Doses of 100 to 500 mg per day for one month are recommended for mental support, followed by a maintenance dose of 50 to 100 mg per day.

Tyrosine
Tyrosine is an amino acid that was studied by the U.S. military for its potential to help soldiers cope with the stress of battle. Their studies showed that 2000 mg of tyrosine helped memory and cognitive ability during stress. Studies, with volunteers exposed to stressful situations such as shift work, sleep deprivation and fatigue, found that 100 to 200 mg per day helped to prevent declines in mental performance and increased their ability to concentrate. Other amino acid groups, referred to as the branched chain amino acids (BCAAs) have been shown to counteract the rise in cortisol and drop in testosterone and immune function that is often seen in endurance athletes. Although tyrosine and BCAAs are available in supplement form, they can easily be obtained from protein foods. Hence, the recommendation above to increase protein content of the diet.

Adaptogenic herbs

Ginseng
Ginseng is the best known of the adaptogens. Many animal and human studies have shown that ginseng can increase energy and endurance, improve mental function and improve resistance to various stressors including infection, extreme exercise and sleep deprivation. Human studies have shown improved immune function and reduced incidence of colds and flu with Panax ginseng 100 mg per day. Siberian ginseng (Eleuthrococcus), while not a true ginseng, contains compounds that give similar effects. While generally considered safe, ginseng has been reported to increase blood pressure in some individuals, and caution should be used in those prone to hypoglycemia, due to its reported effect of reducing blood sugar levels.

Schisandra
Schisandra is a traditional Chinese medicine used to promote energy, protect the liver, alleviate exhaustion and correct immune system disturbances caused by stress. It is generally considered safe when used in recommended doses of 100-500 mg per day, although mild indigestion and skin rash has been reported. Because it may induce uterine muscle contractions, it should not be used by pregnant women.

Astragalus
Astragalus is an adaptogen herb commonly recommended for stimulation of the immune system and for energy-promoting properties. It has been used for centuries both in Traditional Chinese and Native American medicines, and animal experiments suggest that it enhances function of T-cells, lymphocytes and neutrophils. It is often combined with other adaptogenic herbs to keep the immune system functioning during periods of high stress. As a single ingredient it would be used in doses of 250 to 500 mg per day, or in combination as 100 to 200 mg per day.

Treating the cause

Many of these herbal medicines are available in combination “stress formula” products, and this is often the easiest way to supplement with them. People with high levels of stress on an ongoing basis would be well advised firstly to maintain a healthy diet and supplement with vitamin C, vitamin B complex and magnesium. If they are having difficulty coping with chronic stress or if stress is causing detrimental physical effects, they should next consider taking cortisol-modulating supplements as well. Adaptogenic herbs, available as combination products from several herbal manufacturers (for example: AdrenPlus from Enzymatic Therapy, Corti Lite from Vita Plus), would generally be used periodically during episodes of increased stress to counteract the detrimental effects of elevated cortisol.

Animal studies have shown that stress-induced rises in cortisol levels lead to increased visceral (in the abdominal cavity) fat deposits that are associated with disease states such as diabetes and heart disease. It would appear that we are focusing on treating all the diseases caused by excessive stress, while ignoring the “elephant” in the room. Perhaps the tools described above, along with improvements in diet and lifestyle, can help us to become healthier and improve our chances of avoiding chronic disease.

Originally published in Drugstore Canada