Posts Tagged "stress"

Bringing back the woo-woo…or the ‘ain’t no woo woo.’ Mindfulness, meditation and stress

Posted by Liz on Dec 9, 2011 in anxiety, health, general, Meditation/mindfulness therapy | 0 comments

Are you familiar with the end of the year crunch? I’m in the midst of it and although life is scheduled to slow starting next week, I am finding that I am having difficulty keeping up. So, today, I’m bringing back the woo woo in hopes that it might influence my own inability to calm down the adrenals right now.

Apologies for being self-serving. To be truly honest, this is one of my favourite posts of this year so I’m bringing it back. One word at a time. Let’s start with the first:

Relaxation.

It’s so elusive for many of us. And yet, so important to our overall health and wellbeing. In fact, researchers are finally discovering how relaxation actually counters changes that occur in our bodies that result from exposure to constant stressors.

For decades, Dr. Herbert Benson, founder of the Mind-Body Institute in Cambridge, MA and an associate professor at Harvard University, has been writing about the relaxation response, a “mind-body intervention that elicits deep changes in the physical and emotional response to stress.” Strategies that elicit the relaxation response include meditation, yoga, tai chi, Qi gong, deep breathing, controlled muscle relaxation and guided imagery. And although many would like to point to the “woo woo” factor at-play, an evolving and wide body of published literature is indicative of how interested the medical community is in the mid-body connection and the positive changes that these practices promote, including a slowing or heart rate, a reduction in blood pressure, improvements in blood sugar and fats, and even boosts in our immune system. However, what has long eluded researchers is what actually happens in the body to achieve these improvements.

In a novel study published in 2008 in PLoS ONE,  Dr. Benson and his colleagues looked closely at 19 volunteers who had practiced relaxation response strategies (e.g. meditation, yoga, repetitive prayers) for as long as 20 years and compared them to 20 novices, individuals with no relaxation practice experience. These novices were provided with training sessions for 8 weeks that included information about how to reduce daily stress and the relaxation response and a 20 minute, individually-guided session comprising diaphragmatic breathing, a body scan and meditation.For 8 weeks thereafter, the novices then used a 20-minute relaxation CD at home and were asked to review the informational brochures. Blood samples and analysis of gene expression between experienced and novel relaxation practices, and pre- and post-training were then compared.

Importantly, while the researchers observed distinct changes in the genes in experienced relaxation practitioners compared to novices, when the novices started to incorporate relaxation practice into their lives, they also started to express similar positive alterations in their genes. Moreover, these changes are directly related to how cells respond to stress and create free radicals and inflammation that can lead to long-term damage. Additionally, type of relaxation strategy that was practiced was of no important; by achieving a relaxation state, individuals could make positive changes in their cellular structures thought to promote health.

Both inner and outer psychological states and environmental factors play a role in how women experience peri and post-menopause, their self-esteem, attitudes and severity of symptoms. If a daily practice of some sort of relaxation strategy can actually alter genes in a way that improves health and well-being, why can’t that daily practice also improve the menopausal/midlife experience?

While I’ve long embraced the idea, I’ve never actually made a concerted effort to incorporate some sort of relaxation strategy into my daily activities. I’m going to change that. Ain’t no woo woo but a woot woot so far as I can tell.

Wednesday Bubble: Can yoga decrease insomnia, improve sleep quality?

Posted by Liz on Nov 9, 2011 in aging, menopause, sleep disturbance, stress, yoga | 1 comment

I love that yoga practice continues to take center stage in Western medicine. Truly, this is mind boggling because rarely, if ever, has an alternative practice been given so much credence within the confines of a medical philosophy that allows little outside the box. However, just a few weeks ago, yoga made the headlines again with data showing that it might be useful for treating lower back pain than standard therapies.

In menopause, yoga practice has been explored for stress relief, to improve wellbeing and as a tonic for vasomotor symptoms. Notably, the latter are considered to be partially responsible for significant sleep issues that occur during and after menopause. Indeed, some data show that up to 81% to 83% of women may have sleep complaints and 52%, insomnia.

Yet, like many strategies, yoga is not a one size fits all practice and there are many branches and types, some being meditative and others breathing, and some more physical than others. These distinctions can make it difficult to standardize studies and apply their results. Still, I was thrilled to stumble across a study evaluating the effects of a specifics sequence of yoga on physical and mental health, and symptoms in menopausal women experiencing insomnia. Importantly, this study used a scientific, randomized controlled design to insure that test conditions were up to par with Western methodological standards.

Basically, researchers assigned 44 menopausal women diagnosed with insomnia to one of three group:

• a control group who ingested 500 mg calcium daily
•  a passive stretching group, who participated in two, one hour passive stretching classes a week (including stretching of back, stomach, ankles, knee, thigh, elbow, shoulder, wrist and neck) or,
• a yoga group consisting of two, one hour sessions weekly. These yoga sessions were based on a sequence using stretching positions (asanas) with strong and fast breathing (bhastrika) followed by directed relaxation.

Women in these groups also took 500 m g calcium daily.

The study, which lasted for four months, showed that engaging in a particular sequence of yoga significantly reduced vasomotor symptoms and improved sleep/insomnia severity and mental health compared to passive stretching or simply taking calcium. Women who took the biweekly yoga classes also had higher quality of life scores and better resistance to stress. And while the passive stretching group certainly did not do as well, they did trend towards these benefits as well, especially with regards to the degree of reported stress in their lives.

The researchers believe that regular yoga practice, at least with these particular sequences, alters the nervous system and increases brain concentrations of a potent neurotransmitter – λ-aminobutyric acid – to help improve sleep patterns and reduce vasomotor symptoms. Likewise, stretching may lead to a state of calm that results in reduced metabolism, heart rate, blood pressure, breathing and muscle tension, all of which contribute to stress (or stress reduction).

Granted, this is a small study but it was rigorously designed and suggests that yoga may help sleep issues associated with aging and menopause. I, for one, want to run into a yoga studio. I don’t recall the last time my zzzz’s were not interrupted.

Wednesday Bubble: Timeout

Posted by Liz on Oct 19, 2011 in aging, menopause, stress | 8 comments

Back in 2009 I posted a story about a woman’s death being blamed on menopause. It seems especially poignant a day after World Menopause Day, a day unlike any others, when we put down our prejudices and celebrate everything menopause.

As my grandmother would say “oy vey.”

How about we focus on how, as women, we are constantly manipulated by ‘disinterested’ parties? How about we call “timeout?”

A bit of context…

In 2009, the BBC ran a story about a woman who committed suicide. The headline read:

“Woman’s Death Blamed on Menopause.”

“A woman who refused to take hormone replacement therapy died while suffering a menopausal episode, an inquest had heard. Margaret Drew…was killed when she walked out of her family home on to a nearby railway line and was hit by a train…There is no trigger to this at all, except hormones making her do things that she normally wouldn’t do, Dr. Carlyon [Cornwall Coroner) concluded…”

Menopause. The silent killer. Oh really?  Drew’s husband claims that his wife was “delightful, lovely and friendly” 99% of the time; the other 1% she’d become “totally irrational.” Yet, she refused to try HRT, he says. On the day of her suicide, he said that his wife was “clearly angry about something.”

Something.

Obviously, the conclusion is that that the “something” is hormones. This reminds me of vintage advertising copy that conveys the simple message that a pill a day can cure all that ails, wipe away the tears, mood swings and instability so that women can “transition without tears” (or better yet, without killing themselves).

Notably, a search in the National Library of Medicine’s PubMed database turned up only one recent study specifically dealing with suicide ideation across reproductive stages. In it, researchers compared data in 8,794 women, and found an increased risk of thinking about suicide among women during perimenopause, not before or after entering menopause. These findings remained after controlling for risk factors such as anxiety and mood disorders. HOWEVER, the researchers noted that the study design did not allow them to form any definitive conclusions about the specific reasons for thinking about suicide.

Another search yielded information that the risk for a major depression increases during perimenopause, primarily as the direct result of vasomotor symptoms. The same does not hold true for women before menopause begins or once they enter menopause. Note that while major depression is a risk factor for suicide, not everyone who is depressed will actually kill themselves.

Are hormonal fluctuations the sole cause of such deep unhappiness that women want to kill themselves? Or their careers?

Let’s look at a more recent story that appeared this week in the Denver Post.

“Former Elbert County assessor blames menopause medications for crimes, is sentenced to 60 days in jail, fined $10,000”

“Elbert County Judge Jeffrey Holmes might have thrown the book at former county assessor P.J. Trostel just for her management skills alone. Instead, he sentenced Trostel today to 60 days in county jail, three years of probation and 200 hours of community service on two felony counts…In asking for leniency, Trostel and her lawyer said a variety of factors led her to make bad decisions. Those included depression, symptoms from menopause, medications and stress from family and work. “Some of the things I don’t even have an answer,” Trostel said. “I know I made terrible judgments and decisions.”

It sounds as though Trostel would have done better with different legal representation. And a sounder argument.

And while Trostel is chewing on that concept for the next six years while incarcerated, perhaps we can start to change the paradigm and focus on the ills of the Menopause Industrial Complex, disinterested parties who perpetuate societal myths that menopause is a disease that requires treatment and that as women, our attitudes, belief systems and actions are hormonally-based and driven. That we are hysterical beings who need guidance on how to find our way and fulfill our dreams, realize our paths, but only if we calm down. That we can’t hold a job down, keep a marriage intact or play nicely with others. That we need a timeout (this would entail a long, long time, by the way).

Seriously though, a timeout from the hype would be a welcome addition to the change, don’t you think?

Wednesday Bubble: Hot flashes? Try a little mindfulness…

Posted by Liz on Mar 16, 2011 in mind-body therapy | 1 comment

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No bubble bursting or woo woo. I’m talking the real deal. And if mindfulness doesn’t lead to a wee bit of tenderness, well, I don’t know what will. But enough of me taking poetic license with Otis.

Back in January, I wrote about a piece about the relaxation response and how a daily relaxation practice can actually alter gene structure and induce cellular changes believed to promote health. In the post, I said that “both inner and outer psychological states and environmental factors play a role in how women experience peri and post-menopause, their self-esteem, attitudes and severity of symptoms. If a daily practice of some sort of relaxation strategy can actually alter genes in a way that improves health and well-being, why can’t that daily practice also improve the menopausal/midlife experience?”

Guess what?

It appears that I might have been correct.

Writing in the Advanced Online edition of Menopause, researchers say that women who learn to recognize and more accurately discriminate the components that make up an experience, e.g. thoughts, feelings and sensations, or more specifically, the degree of bother and stress related to hot flashes, may be able to reduce the impact of the flashes on wellbeing.

In this 20 week study, women who were late into the transition into full menopause or in early menopause who reported experiencing, on average, 5 or more moderate to severe hot flashes/night sweats a week were assigned to 8 weekly mindfulness-based stress reduction classes  plus one, all day weekend class or to a waiting list. These classes, which lasted 2.5 hours at a time, involved the following:

• Focused awareness of gradually moving thoughts through one’s body from the feet to head while lying down, paying close attention to bodily sensations
• A sitting meditation focusing on breathing
• Mindful stretching
• Learning materials that discussed how to apply mindful stress reduction practice to everyday life and specifically in response to distressing symptoms and situations.

All participants also completed daily hot flash diaries to rate how bothersome their hot flashes were throughout the study period. Additionally, the researchers analyzed the intensity of hot flashes, quality of life, sleep quality, anxiety and perceived stress, as well as medical history, smoking, previous experience with mindfulness practices, and factors directly related to flashes such as smoking, body mass index, alcohol use and physical activity.

Granted, this study is a small one. But the researchers found that mindful stress reduction practice significantly reduced hot flash bother over time by almost as much as 15% after nine weeks and by almost 22% by 20 weeks, compared to at least half as much in women who were on the wait list. Moreover, sleep quality improved considerably!

Overall, the researchers say that their findings truly highlight the role that stress in general, and mental stress in particular, play in how we perceive hot flashes, how much we are bothered by them, and even their severity and frequency. However, they also say that the fact that mindfulness practice did not affect the intensity of hot flashes shows that it might simply help women cope better with them. Less clear is how the degree to which the placebo effect played a role; studies of pharmaceutical treatments report a subjective placebo effect of up to 30% so it’s not out of the realm of possibility.

Still, they believe that their data show that mindfulness stress reduction may be a significant resource for reducing the bother of hot flashes. Overall, it’s a win-win. Calm the mind; calm the body. Why not try a little tenderness with yourself?

Wednesday Bubble: stress, abdominal fat and exercise

Posted by Liz on Mar 2, 2011 in exercise | 4 comments

This is a day to neither burst nor unburst bubbles, but rather, explore an interesting set of hypotheses that ran across my desk:

Stress boosts that unsightly bulge around our midsection as we age. And, high intensity, intermittent exercise might eliminate some of it.

It’s hard to stay away from the the battle of the middle age bulge. It’s there every time many of us look in the mirror. And as I’ve written time and again; in women, the accumulation of abdominal fat is the perfect storm, multifactorial in cause and affecting a majority despite diet and physical activity. The culprits? Experts believe that it may be related to changes in ovarian function, hormone and just generally aging. To add insult to injury, as estrogen production declines, the body starts to rely on secondary production sites, such as body fat and skin. Thus, fatty tissue starts function like an endocrine organ instead of simply a passive vessel for energy storage. The body also struggles to hold onto bone mass and may compensate for its loss by holding on to extra body fat longer.

Now it seems that there’s another culprit at play: stress.

Cortisol is a hormone that is secreted by the adrenal glands. Its primary role in the body is to regulate energy (by producing blood sugar or metabolizing carbohydrates, protein and fats) and mobilize it areas in the body where is it most needed; consequently, cortisol levels tend to peak in the early morning and then gradually decline throughout the day. Cortisol is also produced in reaction to prolonged periods of stress, during which time it produces protein that the body can convert to energy. However, it also increases the creation of fat that may be deposited in fat cells residing deeply in the abdominal area.

Aging is believed to create further imbalances and an increase in cortisol levels, especially at night.  Recent data have also shown that overall, women have higher cortisol levels than men, and that certain women, especially those with greater amounts of abdominal fat, may be reacting to a large disruption in release of cortisol that causes a greater than normal difference between morning and evening levels of the hormone. This disruption is believed to be related, at least in part, to exposure to prolonged physical and mental stress.

If you are anything like me, your adrenals are working overtime and stress is pretty much a given part of your life. And, those abdominal fat deposits that were for most of your life, kept at bay, are starting to show up in the most inopportune places.

Now for the good news:

According to a recent review in the Journal of Obesity, there is accumulating evidence that high-intensity, intermittent exercise ( e.g. 8 seconds of high intensity cycling to significantly boost aerobic capacity followed by 12 seconds of low intensity, over a 20 minute period) performed at least three times a week may effectively reduce abdominal fat and even fat that lies just below the skin. The most important thing is consistency; although most studies have only evaluated these type of exercise regimens for short time periods, it appears that better results are associated with regular programs that last at least 3 months or more, especially among people who have larger amounts abdominal fat. Less certain, however, is the role that age may play, and if imbalances in cortisol levels due to prolonged stress influence how well intermittent, high intensity activity impacts fat deposits.

Not only have I upped the ante in terms of how long I exercise daily (i.e. 6o minutes) but I have started to pay more attention to how I’m working out in terms of intensity levels. Next up is the addition of intermittent high intensity intervals. Regardless of whether it’s cycling, elliptical or running, I’m hopeful that I can combat some of the bulge that’s creeping up. If anything, my heart is going to thank me!

What about you? In addition to watching what goes into your mouth, what are you doing to combat stress and that rotunda around your midsection?