Monday, June 19, 2017

Stress Reduction

My new goal in life is stress reduction.

Correction: There's no way to actually reduce stress.  Life is stressful.  In my line of work, I see people every day who are dealing with much more stressful situations than me.  I could say that once my kids are a little older, things will be easier, but there's no guarantee of that.  From everything I've heard, dealing with teenagers isn't a walk in the park.  The job I took that was supposed to be part time and low stress has evolved into something that's not really part time and somewhat stressful.

So my goal is to improve the way I deal with stress.

A little background:

I'm someone who tends to somaticize my stress.  This has manifested itself in many different ways throughout my life.  In my mid thirties, it's mostly been musculoskeletal.  For a while, I was doing well, but a recent big stress caused everything to get worse. Lately, I've had constant tightness in my upper traps that I can't seem to get rid of. When I'm feeling good, I can ignore a little muscle tightness, but when I start focusing on it, it becomes this terrible pain that takes over my whole life.  As a physiatrist, I know and use every modality there is, but I recognize that a large part of it is psychological.

My problem is that I'm not a spiritual person.  The idea of sitting and meditating is very, very hard for me.  I've tried countless times with little success.

How can I achieve my goal of stress reduction? Has anyone been successful with this? I'm determined to do this, because I see myself going down a path that frightens me.


21 comments:

  1. What kind of exercise do you do, Dr Fizzy? I walk/run. I can zone out and just focus on the walk/run either to music I love, or on the treadmill watching shows I enjoy. That is my form of meditation, I am not very spiritual either.

    With the musculoskeletal thing you mention I wonder if Pilates or Yoga might be a helpful thing, if you do not already do that. :)

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    1. I tried yoga and hated it. I do stretches in the morning and that's it. I do love to walk with music, but not sure if that's zen enough.

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    2. Sounds like you need some exercise to get your endorphins running. Working your body will work out some of your anxieties as well. It's not a cure-all but it does help.

      Try something different--not running or yoga or Pilates. Try a circus school if you have one nearby. They teach contortion classes, aerial silks and trapeze classes. It sounds super hard but it can be learned fairly quickly, it's a lot of fun and it works out all of those muscles at once.

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  2. This is something I've struggled with for a long time, and like you I haven't had success with sitting and meditating (or other stress reduction techniques). I recently started working with a performance coach who works with physicians, and he has been a huge help at reducing my stress. He's helped me to identify the aspects of my job that are most stressful and to find ways to either eliminate/minimize them or cope with them better, and it has made a huge difference in my stress/happiness level.

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  3. I see a counselor once a week for the mental, which doesn't necessarily de-stress, but does bring in a person who's sympathetic and periodically gives insight and advice.

    For the physical, I've seen a really good PT and also a running coach.

    I don't really meditate, but I do try to consciously relax. There are times when "do less" needs to be my motto.

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  4. Exercise can help as can a good massage. I have gotten good at napping which can work as an escape. I'm not spiritual, either. My stress would manifest as zits, hives, or shingles when I was younger.

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    1. I used to get massages, which I liked, but it wasn't that stress reductive.

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  5. There's the story of the Trouble Tree.
    http://www.amyreesanderson.com/blog/the-trouble-tree-leaving-stress-at-the-door/#.WUf_XvnyuUk

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  6. You can work with your doctor to try to find medication that helps both emotions and muscle pains. For me, reducing children's afterschool activities made a big difference. Also, I have down time at the end of the day just for me.

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  7. I up my magnesium intake when my mind and muscles become too tense. Start slow if you're going the supplement route. Too much can cause diarrhea. I love the powdered Natural Calm product.

    Also try to cut out sugar and alcohol. Both tend to increase my overall anxiety although they feel good at the time of consumption.

    If meds for a short time can help you enough to support the development of healthy habits, I'd consider it. I've heard gabapentin is good for anxiety. In your line of work, you already know all the options for muscle pain.

    What you do sounds really stressful. I have a lot of respect for you for wanting to help people day in and day out. Ultimately if you can't maintain your health, you won't be able to help anyone, so somehow you have to stop putting your needs off (or at least start cutting down on the amount of times you put your needs last).

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    1. I don't drink alcohol or caffeine. I don't eat many sweets either. I feel like I don't want to start taking a med just because I'm too lazy to take care of myself...

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    2. I feel so bad for you. Really, what is the solution?

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  8. I think meditating is supposed to be "hard". It's essentially mental exercise and can be as spiritual or secular as you want it to be. I don't consider myself spiritual either.

    I just came back from a 7 day silent retreat. I've been meditating for a few years and have seen real benefits from the practice. I'm by no means an expert but I think there are a lot of misconceptions about meditation; that you're supposed to empty your mind or sit contorted in an uncomfortable position without moving for hours. What I do is sit and try to focus on my breath. When something happens that draws my attention away from the breath, I notice it as soon as I can and return my attention to the breath. (This is Vipassana or insight meditation). I do this for 15-20 minutes a day.

    If I have pain somewhere, I turn towards it and try to be curious about it. I tend to get a lot of lower back pain if I'm stressed out. I find the more I try to push it away and ignore it, the worse it gets. If I actually start to observe it, I can feel it changing and loosening and dissipating.

    There's lots of different types of meditation if sitting doesn't work for you. Like walking meditations, body scans lying down, standing meditations. I'll stand if I feel sleepy, for example.

    I don't know how you have approached meditation in the past but the most useful ways for me have been attending a retreat or talk by an experienced teacher, the 8 week MBSR course (there are free ones online), guided meditations (Tara Brach and Sharon Salzberg have podcasts), the Buddhify and Headspace apps, reading Jon-Kabat Zinn's Full Catastrophe Living (secular, not spiritual), trying to bring mindfulness into the rest of my life (eating, working, walking, working out/my athletic endeavors).

    Apart from that: eating healthy, exercising every day, spending time with friends and family, and getting enough sleep.

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    1. I did some Kabat-Zinn meditations. They used to make me fall asleep!

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    2. Yeah, this is a really common problem. For me, it's usually a sign that I'm sleep deprived and need more sleep but sometimes it just happens. There are some traditions where they hit you with a stick to prevent you from falling asleep, ha ha.

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  9. Yes! I was going to say the book Full Catastrophe Living, but I see someone already beat me to it!

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  10. Meditation never worked for me. I have a hard time staying focused on the act of meditating; there are just so many other things I'd rather be thinking about, including pleasant thoughts. And since it takes all of your focus, you need to set aside special time to do it. Maybe I just never spent enough time working at it to get the benefit, and I'm certainly not trying to disparage it, but I think it's the default thing that people turn to when there are many other options.

    For me, what I use most commonly is music. When I'm at home the music is almost always playing, and same when I'm driving. I usually don't have time at work to listen to music, but during really slow periods (like when working nights) then sometimes I'll listen to music there, too. I used to listen to high-energy music when I was younger, but I've transitioned into primarily piano and new age music (and if I want a bit more energy, "chillstep"). They have beautiful melodies, they're calming, and music - at least for me - has a large effect on my mood and perception. I've had to switch up to pop music at times because the other melodies had too much of a depressing effect, combined with other things that were happening in my life.

    Other things include heading out into nature and being involved in art. I merged the two and got into nature photography. For some people, doing a sport gives you the same effect. The trouble is, since entering medicine and having a child I haven't really had the time to do those hobbies. I'm guessing you're in a similar spot (and this suffers from the same problem that meditation does, as it requires dedicated time). But if you can figure out how to integrate something, it should work nicely.

    Lastly, there's a bit of life philosophizing and thought. It's not about being spiritual, really, but about trying to remind yourself of the bigger picture. Our emergency department has a scroll with some saying from Confucious, about how we become our thoughts. So make a conscious effort to redirect your thoughts as you respond to your day-to-day scenarios, and over time it gets easier... and the benefit for us, working with people who are suffering from terrible ailments, is that we can constantly remind ourselves of how lucky we are to be living in what is comparatively great health. (Not to downplay our own suffering, but to remind ourselves that certainly it could be much worse, and that we have a lot to be thankful for.)

    And at the end of the day, sometimes you can only change yourself so much, and the problem really needs external changes to be resolved. If the job has become something it wasn't supposed to be, or it's really rubbing you the wrong way, maybe it needs to change. You can't run away from your family, but if something there is causing friction then maybe your husband can help in some way.

    Hang in there.

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    1. So... it's not actually true that you need to set aside special time to meditate. You can meditate washing the dishes, for example; the key is to be mindful about it.

      Meditation is also not necessarily about eradicating pleasant thoughts. But when you talk about "making a conscious effort to redirect your thoughts as you respond"... that actually falls within the scope of meditation. So... you're meditating and not even realizing it.

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  11. as a pre med my mom got diagnosed with cancer. i started training for marathons. the clear goals and regimen forced me to exercise and relieve stress. having a large but attainable fitness goal that requires effort and practice may help switch the focus from stress reduction (which makes it stressful in itself) while providing the same stress busting benefits.

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  12. If it's stress in your traps its a sign your upper back isn't very strong and your core might not be as well. I'd recommend weight lifting with a personal trainer as we always strengthen what is already strong and ignore what is weak as it's hard.
    I also find that if you are feeling stress you are doing too much. Outsource what you can - to your husband or kids. Are you distributing chores equally and appropriately. Can you hire help?
    Say NO - to anything extra
    Find your passion - what do you do for fun? Or at least what did you use to do for fun? (you don't have to be good at it) Seems like drawing was a passion - are you doing it? Sign up for a class to reserve that time.
    Unplug and prioritize playing with your kids
    SLEEP
    Control your bloodsugar. You can't manage much stress, but you can handle that one.
    Good luck. You are a work in progress

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  13. Dr. Fizzy, its 1 am on my side, so did not read all comments, ignore if it's been said.
    But try a few Reiki sessions. Just try at least two.

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