From the Archives: Mindfulness in Trying Times

If you’ve been feeling more stressed than usual, you’re not alone.

According to the American Psychological Association’s latest Stress in America report, more Americans are feeling more maxed out than ever. Over half – 57% reported significant stress over the political climate in particular.

None of that comes as a surprise to Dr. Ron Samarian, who is the chief of the department of psychiatry at Beaumont Hospital in Royal Oak, Michigan. At least once a day, a patient comes to him with anxiety related to politics.

“Some of the things we’re seeing are really unprecedented,” he said. “The fear of uncertainly is a constant, whether it’s political or otherwise. We seem to have an unprecedented level of political uncertainty, which can feed into the fear of disunity of the country, fragmentation of relationships. For example, neighbors that don’t agree with us, friends, family, and even of course the safety of our loved ones and the security of our finances.

“Certainly in our lifetimes, it’s never been this distorted. … It hits a lot of different areas all going to the same place, which is the uncertainty and the lack of control or the feeling that we don’t have as much control.”

Such stress can come out in many ways: anger, fear, anxiety, grief, dread. This can take a big toll on mind and body alike.

One healthy way of confronting this stress is through mindfulness practices. Here’s how Buddhist monk Phap Dam – a senior disciple of the renowned Thich Nhat Hanh – recently explained it in an interview for Vox:

We see the mind like a house, so if your house is on fire, you need to take care of the fire, not to go look for the person that made the fire. Take care of those emotions first; it’s the priority. Because anything that comes from a place of fear and anxiety and anger will only make the fire worse. Come back and find a place of calm and peace to cool the flame of emotion down.

Meditation provides a route to that place of calm and peace.

Meditation is not an esoteric practice; it’s not something you do only in a meditation hall or Buddhist retreat center. It can happen right in whatever activity you’re doing — while walking, in the office. It means you are there, present with calm and peace.

With a breath, you can bring calm, clarity and rest your thinking.

Learn more about the healing power of mindfulness in this excellent talk by Jon Kabat-Zinn:

View more videos on mindfulness.

Originally posted February 21, 2017; updated

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When Medical Issues Have a Psychological Component

Think about a time when you were really stressed out – the tangle of anxiety, anger, fatigue. Maybe your stomach hurt or you got a headache or back pain set in. Maybe your chest felt tight.

And just as mental states can have physical expression, physical issues can affect our mental states.

In fact, many medical problems can have psychological symptoms. One 2015 paper in the Psychiatric Times lists dozens of illnesses that can present as anxiety, along with 30 types of medication that can cause anxiety.

A JAMA study published just this past week found that 37.2% of US adults use medications that can cause depression. These include painkillers, proton pump inhibitors, beta blockers, anticonvulsants, anti-anxiety drugs, and more.

Metabolic disorders can look like psychosis. Endocrine disorders can look like depression. Neurological illnesses can present as an anxiety disorder. The mental may mask the medical. As psychiatrist Ronald J. Diamond has noted,

The depressed patient may have an under active thyroid gland. The patient with panic attacks may have a pheochromocytoma, a tumor that secretes epinephrine. And the patient, whose personality change and increased irritability is thought to be caused by his marital problems, may actually have a brain tumor causing the personality changes and exacerbating longstanding marital issues.

Maybe the most common example of a medical issue appearing psychological is mercury or other heavy metal toxicity, famously embodied in the character of the Mad Hatter. Back in the 18th and 19th centuries, the felt used in making hats was treated with mercury, and long-term exposure caused symptoms ranging from tremors to seizures and even hallucinations.

“Brain fog,” depression, anxiety, memory problems, even psychosis have been associated with mercury. More, many of the chronic illnesses associated with mercury toxicity – MS, Alzheimer’s, ALS, cancer – are those that can present as psychological problems, as well.

Another common denominator is chronic inflammation. One recent paper found that even after controlling for a wealth of lifestyle factors, there was a persistent link between psoriasis – an autoimmune condition – and depression. Those who were depressed also ran a higher risk of developing psoriatic arthritis. As Time reported,

This suggests that the depression itself, or the root cause behind the depression, has a direct influence on the development of psoriatic arthritis.

That makes sense, since psoriatic arthritis is triggered by inflammation in the body, says [Dr. David ] Gitlin (who was not involved in the study). Research over the last 20 to 30 years has shown that inflammatory processes can drive the development of depression, he says. “We now know that those processes are likely similar to those that drive some physical illnesses, as well.”

When physical illness presents with mental health challenges, treating the root of the latter can help with the former. But it’s important to remember that although the psychological effects may be part of the systemic illness you are addressing, what they bring forth is real, legitimate, and worth working through. Physical detox, for instance, can waken memories of trauma that can be quite troubling or overwhelming.

This is why it’s so crucial to have psychological support for that part of your experience – family and friends, of course, to offer comfort, but also a counselor or other psychological professional who can work in tandem with your physician to help you work through the issues that come up, regain emotional balance, and grow through your experience.

It’s something Dr. Joe recommends, in fact, so the emotional aspects of healing can be dealt with in a deep and meaningful way, even as he focuses on addressing the physical issues on the road to Radiant Health.

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