I recently blogged about the stress that often accompanies the practice of medicine. Although I mentioned several behaviors to avoid, I realized that I didn’t really provide any proper suggestions for managing the daily stressors that all of us feel (no matter what our occupation may be). Patients, in particular, deal with high levels of stress. These stressors are numerous and may include financial, health-related, job and family/relationship related. Cardiovascular illness can certainly be exacerbated by emotional stress. Stress raises levels of catecholamines and other stress hormones are also released. This “high stress” biochemical state can precipitate acute cardiovascular events in susceptible patients.
As I was researching the previous blog I came across a lot studies that examined stress reduction techniques. The strategies were quite varied; some simple while others were complicated and elaborate. As I poured through tons of research papers (some good and some not so good), I asked myself, “What is a strategy that almost anyone in the world can utilize to manage their own stressors?” I became particularly interested in those that evaluated both breathing techniques and yoga for stress reduction. I am a scientist at heart. I typically recommend therapies to my patients that have been well studied and typically evaluated in randomized controlled clinical trials. However, the management of anxiety, stress and the like is not as easily evaluated as a new drug for the treatment of congestive heart failure. Individual emotions, personal differences in perception of anxiety and stress, and environmental factors make these subjects difficult to study.
A study in the International Journal of Yoga in 2012 examined the effect of yoga on stress in dental students performing their very first surgery. 100 dental students were randomized to either a set of 60-min stress reduction lectures or to 60 minute yoga sessions. The yoga sessions focused on simple breathing and beginning moves. The students’ level of anxiety in both groups was evaluated by two separate validated and reliable questionnaires both before and after their first surgery. The group that was trained in yoga breathing related a significant reduction in anxiety and had superior academic performance as compared to the lecture only group. Another study published in Pain Medicine in February 2012 by Busch et al, examined the effects of deep and slow breathing techniques on pain perception in patients with chronic pain syndromes. In this study subjects that were trained in deep breathing techniques had an altered pain perception and levels of pain and anxiety were reduced significantly
So, how can we all apply simple principles found in Yoga and breathing to reduce our daily stress? Here are a few tips:
1. Practice Deep Breathing Meditation: Find a quiet place and sit comfortably with your back straight. Place one hand on your abdomen and one hand on your chest. Practice breathing deeply and slowly from your abdomen. Breathe in through your nose. The hand on the abdomen should rise and the hand on the chest should remain still.
2. Visualize: Practice deep breathing in a quiet place. Visualize relaxation coming into your body with every breath and stress leaving with every exhalation. Focus on the moment. Try not to think about the day or what is to come in the future.
3. Practice “mini-meditation”: Sit in a comfortable, quiet place without distraction. Close your eyes and try to clear your mind (this is the hard part). Stay unattached to thoughts of any kind. As thoughts enter your consciousness, let them go. As you learn to meditate, the periods between the intrusion of thoughts will become longer and longer. Meditation is difficult and takes practice. Start with shorter sessions (5 minutes) and work up to longer ones.
Stress affects all of us in a negative way. We must learn to manage our stress in order to become more successful in our daily lives. The benefits of breathing, meditation and basic yoga principles are that they are all readily available and require no specific equipment. Most importantly, these activities are free and can be done almost anywhere. Certainly, if you want to learn and focus on more yoga, classes in a yoga studio or gym may be beneficial. However, for relief of daily stress, simple breathing exercises, visualization and meditation may be just what the doctor ordered.