How to manage stress?

Foreign. What is the elephant in the room that people just start talking about? This elephant is associated with an increased incidence of cancer, heart disease. It makes all medications work less. It's associated with anxiety, depression. It's even associated with severe episodes of COVID and long Covid. So what could this be? What is this elephant in the room that we're just not talking about? It's stress. Stress is such a big thing today. And what I'm going to talk about are the top 13 interventions that are shown to lower stress and have evidence based behind them to show these actually are the best interventions for longevity, decreasing risk for cancer and heart disease and improving your overall long term mortality. Which is just a fancy way of saying live longer and healthier. So what are these? We're going to walk through them one by one, discuss them over the next several episodes and minutes. The first place interventions is yoga. Yoga has a lot of data in the realm of anxiety, depression, cancer and even heart disease. The first things have to do with occupational stress and depression. Yoga has been shown to decrease depression and occupational stress as little as one to two therapy sessions a week. It's also been shown to help with Parkinson's patients and cancer patients. Now in these patients, you actually need to do it a little more. 60 minute sessions, two to three times a week. But yoga by itself is a very, very powerful intervention. Mind, body, it's a movement with intensity, with intention that actually helps lower your cortisol, improve your flexibility and activate your brain a lot. The next thing that we're all familiar with, and we know we need more of, is exercise. Exercise is mother nature's natural anti anxiety medication. Exercise by itself works better than SSRIs like Prozac, Paxil, Zoloft for decreasing anxiety and depression. And when you look at any kind of placebo trials, looking at medications, they never ever use exercise as a placebo, because we know it works. Exercise actually burns off your body's cortisol that you build up throughout the day. Cortisol is your stress hormone. And one of the best ways to burn that off, besides being awake, is actually exercise and burn it off. So one of the things that affects your sleep, that prepares you for the next day is actually exercise. What's next? What's the next major thing you can do that's not that big of a time ask. It's actually a 30 minute mindfulness exercise. This is when you take a 30 minute breakout three to four times a week and you focus on something, you journal, you write, you have a mindfulness practice. Mindfulness is just having, is allowing your attentions to be focused on one thing, one singular thing only. There are different kinds of mindfulness, whether it's meditation, whether it's guided imagery. These all have literature showing they can help with PTSD. They're being used by neurologists such as Dr. Brenson at the Buck Institute in California to work with patients of Parkinson's disease. Elite athletes are using mindfulness guided meditations when they're actually visualizing their sport to improve function, brain function, reaction times. Mindfulness and meditation are huge, huge evidence based interventions that can help lower cortisol and stress and improve sleep as well. The thing about it is that there's lots of data for things for ptsd, neurodegeneration, enhanced performance, executive enhanced performance, athletic enhanced performance and overall longevity. One of my other favorites personally that I've used in my own life has been diaphragmatic breathing or other kinds of breathing exercise. Diaphragmatic breathing is when you take deep breaths in, expand your diaphragm, full, fulling breaths and breathe them out. So why are these so powerful? One of the things that they do is they actually activate your vagus nerve by putting pressure in abdominal wall, which is very calming. That's also one of the reasons why smoking is relaxing. Not, not because nicotine relaxes, because it's actually a stimulant, because the actual breathing, the tight breathing associated with smoking actually has a calming effect. We can do this and actually calm yourself. When I, when I personally got Covid, I had really bad anxiety for about, about six weeks. And one of the things I did to break that anxiety, just so I didn't develop long Covid, was to actually start doing meditative breathing practices for 20 minutes twice a day. And within about six weeks, the anxiety that I had from COVID broke. Another thing that has a lot of evidence behind it is using some kind of heart monitor measurement while you're doing a breath exercise or some kind of other guided imagery type thing. Heartmath is one of these that has lots of data behind it where you do breathing exercise of some sort and you look at your heart rate variability, how your heart changes while you're doing that. This actually allows you to do this thing called entrainment. Entrainment is actually teaching your heart to maximally pump, to maximally expand, as well as to have these gaps of change related to breathing. When people are chronically stressed, they don't have this. So what that means is when you breathe, your heart rate doesn't change. You sit down for a while and breathe, your heart rate doesn't change versus kids have this really great. And actually when they as a physician, by listening to kids heart, sometimes you'll listen to the heart and skips beats just from the breathing because it expands and lengthens their heart rate. So doing something like a heart math where you get, you can treat yourself and train can actually help lower your cortisol, improve your neurological system, your sympathetic parasympathetic response. And again, these are all evidence based intervention. There's data and literature behind all of these. The next thing I want to talk about is the three minute mental makeover. What this basically is a kind of gratefulness or Thanksgiving type practice where you think about three minutes, you think about what's good in your life, you can journal it down, you can think of six good things in your life. Good events, happy events. Sometimes people will just pick one single thing they focus on. It's actually kind of interesting. This is one of the things in Harry Potter that Harry had to think about in order to recall his patronus, right? It's kind of interesting the idea of having a, a good thought you focus on and changing your body's physiology, changing your power, your intellect, how you think, having a calming effect. It's so powerful, it's actually, it's actually crept in to the moviemaking and story industry and we don't even realize that it's actually based on data and literature. So next time you think about the three minute mental makeover, think about Harry trying to get in a place, remember a good thought that he can call his patronus. Another intervention that has a huge, huge impact on cortisone stress is actually creative exercises or creative arts. I remember first learning about this when I was in the hospital when occupational therapists would come through with patients after strokes and heart attacks and they come and help them work on new hand things, art, painting, things like that. It wasn't just for the therapeutic benefit after a heart attack or stroke. It actually affects the cortisol and the sympathetic nervous system which you all may know after a heart attack or stroke gets radically changed. Well, this can also apply to any other chronic health care issue or even life in general. Find some creative art with painting. Some people do bird watching, nature walking, crochet. My wife personally, she loves painting. It has a very, very calming effect. When you do this. You almost kind of get into the zone where you lose the sense of time. It's a very, very calming practice. One of the things as well that's very Powerful is nature exposure, forced walking, forced bathing. There's a lot of different terms about it, but just being in nature alone is a very, very powerful calming effect. You can actually get a PhD in Japan on forestry medicine, which is actually the medicine I'm looking at how being outside improves your health. And one thing I've noticed in some of my patients, some of my hunters and fishers, they're actually more males that have OCD and anxiety. It's amazing how many of them tend to be fishers and hunters and things that there's in the outdoors, away from society, away from stress, and able just to relax as well. When you're out in nature, like pine trees, when you smell that smell, you're actually breathing in small amounts of essential oils. Well, we already know how essential oils, when aromatherapy can have a calming effect. Nature does that in a pine forest during trees actually release these. So if you've ever been nature and a forest and have that smell, you're actually smelling low levels of essential oils being released. So being in nature is a very, very powerful tool as well for lowering cortisol and lowering stress. And there's great, great data that being in nature by itself actually boosts your immune system. There's a part of your immune system that I refer to as natural killer cells. Being in nature actually bumps these levels up to actually improve your overall health lowers your risk of cancer related to this. And again, there is literature that backs this up. The last thing I want to talk about is social support or perceived social support. So there's been studies looking at perceived social support, which is the idea that you have, you don't necessarily necessarily have to use it. Just having access to family, friends, local religious groups, society organizations that you know will support you in a time of need. Having that, or at least the perception of it actually enables people to deal with stress better when they've done stress scores to see how people tolerate stressors. Just having social support or perceived social support enables people to handle things better, to recoup better after a stress or a life event. So having meaningful relationships or being in some kind of societal organization where you can have access to that is a huge, huge leverage to help you deal with stress. We've all heard of the fringe paradigm. One part of the French paradigm is the way their culture is so family centric has a, has a longevity effect such that it negates smoking and alcohol consumption. So they have a lower risk of heart disease than Americans do. And we as a culture tend to lack that social support that they have in France. It's called the French paradigm, and many of you probably heard about that before. So those are the top 13 interventions that have our evidence based and data proven to actually improve longevity. When I say longevity, I mean living longer without cancer, without heart attacks, without disease, without a whole bunch of things. And these are all things that are achievable and actionable by the average person. So get outdoors, make meaningful relationships, find a hobby, do a breathing exercise, do exercise, do yoga. These are all, all powerful tools that can change the trajectory of your health, longevity, well being. And no one's talking about them. So there you go. Take care, be well. We'll talk to you soon.