Wednesday, October 10, 2007
Mind body relationship and stress
As a neurosurgeon, I have long been fascinated by the real link between the mind and the body. I guess intuitively we have known for some time that there is an obvious connection, but now scientists are putting more energy and resources toward studying it than ever before. From time to time, I blog about things I've found particularly interesting in this arena, and a story today caught my eye.

There is a negative relationship between workplaces stress and your heart health. Ok, so you already knew that one. But, researchers in Canada decided to take it a step further. They studied nearly a thousand men and women who returned to work after having a heart attack. They were followed for the first six weeks after their return, and then again two years later. They found that people who reported chronic job strain were twice as likely to have another heart attack. Twice as likely! Now, in case you're curious (I was) as to what constitutes job strain, the researchers specifically defined it as high psychological demands with low decision control.

Adding more evidence to the link between workplace stress and heart health was another study that more heart attacks and cardiac events occur on Monday, as compared with any other day. And, apparently, it's not just the workplace that can have a negative impact on your health. While marriage can be good for your health, it is important to be more specific. It's more accurate to say a "good marriage" can be good for you health, and a bad marriage can be awful for your heart. In fact, another study showed hostile, angry relationships can boost the risk of heart disease by 34 percent, as compared with people who are on good terms with their spouse.

No question, stress and the associated effects of cortisol and high blood pressure can be a killer. We are seeing more evidence than ever about this relationship. On the other hand, being able to mitigate stress and the perception of stress can be significantly advantageous. Do you have any of your own stories of the mind/body relationship?
Well I'm little Ms. worry wart and my husband is Mr. laid back, easy going guy who probably wouldn't wake up in the middle of hurricane. He hardly ever gets mad either. In fact I could hit him in the head with a 2 by 4, and it wouldn't tick him off. On the other hand I'm sure to die of heart disease before I’m 40, cause I stress out if the wind is blowing in my favorite direction. So I'm hoping being married to Mr. Laid back is going to prolong my life, cause I need some stress relief. I just hope our marriage doesn't shorten his.

I know that I have to make an attempt to control stress in my life to avoid experiencing a lupus/fibromyalgia flares.

By the way, October is Lupus Awareness Month. I am waiting for CNN to become aware of this life threating, complex, and disabling autoimmune disorder. It is just as important or even more important than breast cancer, due to the fact that people die from undiagnosed lupus and its complications.
Hi Dr. Gupta, I used to work for a Principal Investigator in the field of Social Neuroscience (not a field many have heard of, I bet). I'd recommend reading some of his work. His name is John Cacioppo, PhD and works at the University of Chicago. Some of his recent studies are designed to look at how social connections or their absence (i.e., loneliness) affect health. He's also done some work looking at depression and wound healing. It's interesting stuff for people into that kind of thing.
Dr. Gupta, you really should talk to Matthew Sanford He probably understands the significance of the mind-body relationship better than anyone. Matthew was 13 when he became paralyzed from the chest down in a car accident (his father and sister were killed). For 12 painful years Matthew listened to doctors who told him to forget the lower half of his body—until he discovered yoga and the vital connection between mind and body. He has since dedicated his life to sharing his profound and unique insight as a nationally recognized paraplegic yoga teacher, critically acclaimed author of Waking: A Memoir of Trauma and Transcendence, and renowned expert in mind-body integration. Whether you sit all day in a wheelchair or behind a desk, the mind-numbing effect is similar. Matthew speaks around the country about the importance of having a conscious connection between mind and body and how doing even a few easy stretches from your desk can increase workforce resiliency. Matthew intimately understands how not living vibrantly through one’s whole body takes a heavy toll. There is a way to live fully—despite trauma, illness, age or hectic lifestyle. Matthew is the most captivating storyteller I have ever met; his life story of severe trauma and healing teaches us ALL how to live gracefully and create the intersection between hope and tragedy. He’s on a mission to offer the world—able-bodied, disabled, the medical community, veterans—his profound, yet practical insights on improving quality of life by living a deeper, more nourishing connection between mind and body. Matthew is currently featured on Speaking of Faith
During my undergraduate education I was determined to achieve a stellar GPA. I was pre-med, so my GPA was very important for my competitiveness for applying to medical school. During my final exams for each semester I would spend every waking minute studying. I was driven by a desire to be at the top of my class and also from fear that a grade lower than an A would keep me out of medical school. Without fail, after a week of inactivity, less than desired food intake, and overwhelming psychological stress, I would develop a cold. Many times I would just hibernate due to exhaustion. I always found it interesting to think that a week of tests could lead to me feeling so horrible.

Now that I am in medical school things are dramatically different. After my first anatomy test, which I treated similar to my undergrad exams, I decided that I was not happy putting myself through all of this stress. I wanted to learn because I found the material interesting and applicable to my future as a physician, not for some grade. I also felt that my stress and anxiety over exams only made my life less enjoyable and was maladaptive. This summer I took a mindfulness meditation class called Mindfulness-Based Stress Reduction (MBSR) at the University of Minnesota’s Center for Spirituality and Healing. The class has enabled me to better understand my stress response and to not let my thoughts control me. By focusing on the concrete experience of my breathing, I turn my attention in on myself, instead of getting run by my anxiety. I am amazed at how much control I have over my thoughts, emotions and as a result my physiology. Now after a test week I am rejuvenated and ready to go outside and enjoy the outdoors, not getting ready to grab a Tylenol cold and a box of tissues.

As more studies provide evidence of the powerful negative effects of chronic stress on our overall health and wellness, more emphasis should be placed on empowering patients by teaching ways to deal with stress (from “bad marriages,” “chronic job strain,” etc.). I am excited to learn more about mind/body interventions (and types of complementary and alternative medicine), and to provide these techniques to my future patients.

Thanks for your interesting post Dr. Gupta.
My teenage daughter has been diagnosed with Lupus and other autoimmune disorders. Worry about her daily and future health issues is always with me. Any publicity regarding this disease is appreciated!
Dr. Gupta,
Surely you have heard of Transcendental Meditation, a scientific technique proven to reduce stress and provide deep rest for the physiology.
I am quite sure you cannot openly promote any one particular technique, but T.M. is sublime. I highly recommend this avenue for a person who is seeking a healthy alternative to the hussle of our daily lives.
Thank you for your time.
D. Jones
I am a true believer in the mind-body connection. Durning my MPH training we were required to read "Molecules of Emotion: The Science Behind Mind-Body Medicine" written by Candace Pert. This book takes the reader through a journey of how the chemicals in our bodies connet the mind and body.
50% of knowledge comes from our own personal experience and the remaining 50% comes from observing others pains/pleasures. A diseased mind has a direct impact on the body thereby weakening the immune system. This is one of the reason,most of the people with heart-related illnesses&thelike(HBP,high cholestrol,diabetes,and not diseases like ITP)are advised to change their lifestyle which first requires a change in our mental outlook which in turn results in body action.Infact,i have observed that depression/mind is the root cause of cancer and i lost my own mother to lymphoma and in her case it was true. Happiness requires a true understanding of the body,mind,the external world. Sound mind,sound body. Our body is a wonderful design hard to beat by any technical gadgets. Even if doctors come up with gadgets that mimic our body organs(like robotic hands),it will not be as pleasing/beautiful as our original body part. So why mess up with that beautiful instrument? The way to great life is to keep ourselves mentally and physically fit. Vedas(hindu scripture)is nothing but a detailed study relating the body,mind & God. Many top German Physicists(during and before WWII)believed that the solution to the origin of the Universe lies in the Vedas and it is true. Vedas are highly scientific. Thanks for letting me share some information.
Dear Dr. Gupta,

Hello and thank you, we DVD record and really enjoy your “House Call” segments on CNN. I hope CNN might consider scheduling more of them during the week too, or would announce them more often? I hope everyone knows about it. Thank you so much.

Regarding stress and heart attacks – this is a very serious concern in our family. My darling grandfather and three of my sweet uncles all had major heart attacks that nearly killed them. Added to this within about the past couple of one of thse dear uncles, suddenly passed away while having open heart surgery. It was a terrible shock. (The fourth lovable uncle is fit as a fiddle but has taken time to enjoy life too, and he is the bachelor!)

My darling grandfather and at least 3 uncles would be described as bona fide workaholics. Juggling a million projects at once with little time taken to relax. Deadlines to meet. Go, go, go. But now after all their health shocks, my uncles have made some drastic changes in their lives (some having no choice) to slow down and take care of themselves. (my other uncle is not as good about this and his health is sadly suffering greatly because of it – his life is beyond stressful and we are all so worried about him)

In coping with high stress levels, two of my uncles each recently acquired lovely wooded properties in pretty remote areas, one is alongside a tranquil river. Beautiful. Restful simple cottages. When they need a break they go for long walks or sit by the river or outside nestled in the pretty woods with family. (thankfully we don’t have any hostile or angry family members to worry about!) Enjoying time fishing etc. Peace and quiet. It has helped them to cope with stress, they often remark they don’t even want to leave and always long to return.

In coping with my own personal stress I had already come to that conclusion. It took time but I soon realized that even if I couldn’t control events that were happening to me – surely I could control what I took into my mind and heart!

Dr. Gupta, I realize you are a neurosurgeon, and maybe this is term is wrong but I actually called it “changing my neurons” --- almost like creating a whole new pattern of thinking to help me to cope with the daily pain and stress. It was a deliberate and conscious decision that I made at a certain point. I knew I had to find a way to survive.

As an avid hiker in past years and nature lover – I already had a keen love of the natural beauty of the forest and seaside. It was a cherished hobby, something I loved to do with my friends and family. But after a serious setback after an injury, which caused me the greatest pain and stress, then I truly needed to actually PRESCRIBE this for myself...the necessity to enjoy precious moments of beauty and solitude surrounded by prettiness.

The actual need to hear the birds sing. To enjoy the fragrance of the wild roses. The beauty of the open sea, wild and untamed at times. To listen to the most beautiful music. To read the most beautiful books. To watch the best in movies. The need to take time to take care of myself spiritually, to study and learn more. To take time to enjoy writing. Taking time with prayer to express gratitude for all of it. Then I started to photograph and document all beautiful things around me. It truly changed my life and I feel like I woke up from a coma! :D smiles

Stress is a killer but it is a sad fact of life now that we cannot entirely escape it. But we must try to control it, or find ways to cope as best we can. We tenderly realize that we have only ONE miraculous beating heart....we must try to take the very best care of it.

Thank you again Dr. Gupta, we love “House Calls”, please keep up the good work! Take care. (we are really looking forward to seeing you all in “Planet in Peril” too)

In gratitude, G

"A heart at peace gives life to the body...."
Proverbs 14:30a
"Karoushi" was a big deal in Japan about 15 or so years back. People were collapsing and dying from working too much.

Doesn't really come as a surprise that workplace stress, overworking, etc aren't healthy.

I wish we could do more to adopt QUALITY of work over QUANTITY of hours worked.
Yes. Each day more and more scientific evidence emerge, strenghtening this link between mental stress and its negative effects on the heart. Currently we understand certain types of stress factors are much more dangerous and can definately trigger a heart attack. As a cardiovascular researcher, it would be nice to find out to what degree work productivity is enhanced after enrolling patients who are at high risk for heart disease into wellness-stress reduction programs. A massage and soothing music with each working day, what an incentive.... !
My mother died after a year of suffering where parts of her back were literately eaten away by MRSA two years ago.

This sickness was aquired while being operated in a local hospital in south texas. (name witheld, but I wish it could be made known)

The local doctor did not acknowledge the sickness until we transfered her to another hospital with another doctors. (I wish I could make the doctor known to avoid the same with others)

The same happened in the same hospital with the same doctor one year later ending in death of other patient neighbor

This sickness was aquired because of the lack of cleaniness in the hospital after her operation.

I have pictures of the sickness as it grew in her back. I can provide them if it can help others to prevent and prepare.

Imagine half inch by two inches by four inches of her body being eaten away in a period of six months without doctor nor hospital reaction.

I wish there was a cure, but I thing that it can be prevented with cleanliness (not available at that hospital)
Shame on the Dr. Oz and Dr. Taubes for their appearance on Larry King Live. How could either of these "doctors" allow for a ticker that says "maybe exercise makes you fat." In a country with such thorough medical advancements, such a disservice should never be done to the public. Many intelligent people depend on this show for information and a false idea such as exercising making you fat should not be publicized.
Shame on the Dr. Oz and Dr. Taubes for their appearance on Larry King Live. How could either of these "doctors" allow for a ticker that says "maybe exercise makes you fat." In a country with such thorough medical advancements, such a disservice should never be done to the public. Many intelligent people depend on this show for information and a false idea such as exercising making you fat should not be publicized.
Guilty on all counts. I am a professional woman (securities broker) and I was telling my husband just this morning that I am so stressed at work that my memory is being affected. I had a Pacemaker implanted at 40, four years ago.

Here's the scoop on the horrendous cycle. Since my marriage isn't so good, I work more to escape it. The demands of office further complicate my home life and I work even harder to avoid it more. Round and round we go.

I too love Neuroscience and I joke about going back to Medical school to become a research scientist. I'm glad I found this article today as it reinforces my need to get on a more stress-free program before it is too late.
Dr. Gupta,

I agree 100%. In fact, I honestly think that stress contributes to at least 80% of illnesses. I'm not a doctor, but I've read a lot about the mind/body relationship, and I've seen the effects in my own life.

The more stressed I become, the more prone to colds and flus I get. I'm pretty sure there are studies that document stress' effect on the immune system. And I've seen it with my dad too - when he gets more stressed, his blood pressure goes up.

In fact, I just wrote a blog post about common flu remedies I like, and one of them is visualization, which I believe helps to calm you down and relieve stress, allowing your body to do it's job and heal.

It's here if anyone is interested:

Thanks for your thoughts!
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