UVM Integrative Lecture Series: “Mind Body Medicine: Emerging Science and Economics”
Lecture Type: Online Video (Link Here)
Time: 65 minutes 09 seconds
Date: February 24, 2017
Speakers: Darshan Mehta, M.D., M.P.H.
Topic: Mind Body Medicine
Introduction
Dr. Darshan Mehta, M.D., M.P.H., presents a lecture on the emerging state of mind-body medicine for the University of Vermont Laura Mann Integrative Health Care Lecture Series. Dr. Mehta discusses the current science and benefits of incorporating mind-body medicine to address patients’ needs. He emphasizes that every medical specialty can benefit from incorporating mind-body therapies due to the prevalence of stress and psychiatric conditions that negatively impact the wellbeing of patients. Read below to learn more about stress, coping, and resilience, or watch the lecture by clicking the link below.
This lecture was recorded live in 2017 and posted to YouTube. You can view the lecture directly by clicking the link here.
You can download the PowerPoint presentation for this lecture by clicking the link here.
The State of Mind-Body Medicine
Mind-body medicine is a popular topic today. This is largely because we have to deal with a large variety of stressors daily. This may include paying the bills, interpersonal conflict, traffic jams, and so on. Anything that puts you on edge, makes you nervous or anxious, and initiates your body’s innate stress response, contributes to this struggle. It is a balancing act that both the general public and clinical researchers have recognized as important to our health.
Mind-body medicine is a branch of Complementary and Alternative Medicine (CAM), which we commonly refer to as Integrative Medicine (IM) today. According to the National health statistics report (2008), out of the most used CAM therapies in the United States, three mind-body therapies were within the top six, including deep breathing (12.7%), meditation (9.4%), and yoga (6.1%). The use of these therapies was largely driven by patient interest at the time and not referred to by physicians. However, the medical field has begun to recognize the benefits of incorporating such practices in treatment protocols.
Dr. Mehta has dedicated his work as a practicing physician for the Benson Henry Institute for Mind-Body Medicine, a branch of Massachusetts General Hospital, to research and administer mind-body medicine to address this need. He challenges the current model of healthcare and includes practices that empower patients to take responsibility for their health, enhance peoples’ quality of life, improve health outcomes, and decrease healthcare costs. Below I will review Dr. Mehta’s definitions of stress, his explanation of the biological basis of the stress response, and his findings from current research on the potential benefits of mind-body medicine for patient wellbeing.
What is Stress?
Stress is a word that we use in our daily language. Clinically, stress is a state of arousal that activates the fight or flight response, producing hormones that prepare the body to deal with a threat. Two pathways are activated, including the hypothalamic-pituitary-adrenal axis (HPA) which secretes cortisol, and the adrenomedullary pathway which secretes hormones like adrenaline (otherwise known as epinephrine), among many others.
You may be familiar with the saber tooth tiger example to explain how this evolutionary response prepared our ancestors to fight for their survival. Today, we have more complex societies that activate this same response daily. However, instead of a saber tooth tiger, our fight or flight is activated in response to being late to work, an upcoming test, or even dreading exercise.
Activation of this system differs for different people based on a variety of factors. These may include genetics, experience dealing with a stressor in the past, environmental factors like neighborhood safety, past experiences with trauma, and social support.
How you perceive a stressor is also important. This is called appraisal. For example, one student may view an upcoming test as routine and not elicit any stress response; however, a fellow student may see that same upcoming test as a threat to getting into medical school. Those individual factors contribute to this perceived stress, along with a positive or negative mindset, locus of control (feeling like you can have the power to impact the outcome of the situation at hand), and whether you have a community to support you in times of need.
This stress accumulates over time and causes wear and tear on the body. This is referred to as allostatic load. Poor outcomes like burnout, fatigue, and depression result when this allostatic load outweighs our mechanisms of coping, factors that support our resilience, and social support. You can also conceptualize poor outcomes as a vulnerability to illnesses like metabolic syndrome, decreased immunity, and psychiatric conditions. Luckily, humans are adaptable creatures. We can use mind-body medicine to improve our coping skills and find balance amid nerve-racking circumstances.
“Between 60-90% of healthcare visits are related to stress.”
(Journal of Chronic Disease, 1964)
Building Resiliency
Poor health outcomes from chronic stress are prevalent. Physicians must be prepared to address patients’ need to become more resilient in the face of challenging situations and events through healthy coping mechanisms. One study cited by Dr. Mehta from the Journal of Chronic Disease (1964) estimated that 60 to 90% of all healthcare visits are related to stress. While this study seems to have collected data from two days at a single clinic and is therefore in need of further study and replication, it exemplifies the potential degree of prevalence of patients’ inability to cope with the demands placed on them.
Through the Benson Henry Institute for Mind-Body Medicine, Dr. Mehta and colleagues utilize a three-tiered program to help build patients’ resiliency. These tiers are:
- Establishing an ongoing relaxation practice
- Creating patients’ awareness of stress and negative responses
- Developing social connectedness and healthy behaviors
Establishing a relaxation practice includes mindfulness, deep breathing, and yoga. This activates biological processes that combat the fight or flight response. Additionally, research shows that incorporating a daily relaxation practice has many health benefits, such as enlarging brain areas associated with emotional and behavioral regulation, enhancing cell cycle regulation (an important factor for cancer prevention), decreasing bodily inflammation, and even changing gene expression associated with energy metabolism, insulin secretion, aging through telomere maintenance, and much more.
Relaxation practices help to create awareness of our internal stress. Dr. Mehta discusses methods like John-Kabot Zinn’s mindfulness-based stress reduction (MBSR), in which patients learn to observe their mental processes without judgment. This promotes flexibility, self-compassion, and empathy. It also allows those who practice MBSR to recognize that they are not their thoughts and that these mental processes can be changed over time to create more positivity and openness.
Finally, the community is an essential aspect of mind-body medicine. Isolation has been found to not only reduce resiliency in the face of stressors but has independently been associated with earlier death and morbidity. Connecting with others creates support and encouragement.
Dr. Mehta reviews the research behind additional benefits of incorporating mind-body medicine into healthcare. These include:
- Decreased medical symptoms
- Decreased psychiatric conditions
- Increased health-promoting lifestyles
- Reduced healthcare costs
- Decreased healthcare utilization
- Increased resiliency
I encourage you to watch this lecture to learn more about the science of mind-body medicine and the benefits of incorporating this into healthcare treatment.
Concluding Thoughts
Mind-body medicine can be used to combat chronic activation of the stress response which can lead to negative health outcomes. Using methods like MBSR and yoga, patients can develop improved resiliency and coping skills in the face of stressors. Learn the science backing mind-body medicine and how this can be incorporated into the healthcare field from Dr. Mehta.
Check out the lecture video here.
Download the PowerPoint presentation here.
Visit the UVM Integrative Lecture Series home page here.
Citation
Mehta, D. (2017, February 24). Mind Body Medicine: Emerging Science and Economics. [Lecture Recording]. University of Vermont Laura Mann Integrative Health Care Lecture Series. https://www.youtube.com/watch?v=JACy6b85z34
Disclaimer
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