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SEVAMED GUEST ARTICLE

Emotions and Health

Dr. Ranjan Choudhary (Solanki)*

Historical perspective:
2000 yrs ago Ayurveda and Chinese medicine had recognized the role of emotions in health. As per Tibetan Medicine, the root cause of 80% diseases lies in negative emotions like anger, hatred and jealousy. In 400 BC ancient Greece, Plato, Hippocrates also believed in the integration of mind and soul in the domain of medicine. Beginning in the 16th and 17th centuries, the West began to separate the dimensions of the mind from the physical body. In 1637AD Deseaters philosophically separated the mind and body with the concept of dualism.
These were further strengthened by 
• Redirection of Science          • Technological Advances       • Discovery of bacteria and antibiotics
Fixing or curing an illness became a matter of science and took precedence over the healing of the soul.
Modern medicine:
The growth of modern medicine can be viewed in three eras. Era 1 dates back  to mid 1800 scientists regarded that time the entire world including human bodies as mindless machine. It was materialistic, mechanistic or physicalistic medicine like drugs, surgery radiation so on. Matter only mattered not mind.
Era 2 dates to mid 1900 of psychosomatic medicine. Developed  after world war two.  Beneficial results of suggestion, expectation and positive thinking were brought to forefront. Role of stress in heart disease became evident. Extensive research on Stress  was conducted by Walter Cannon in the same period. Henry Beecher, M.D. proposed   placebo Effect in second World  War 2. Due to low supply of morphine during World   War II, he found that pain could be controlled by saline injections. As a result, since the 1960s, mind-body interactions have become an extensively researched field.
By era-3 Effect of consciousness to act locally as well as non locally will be even further strengthened.
What is good emotional health?
People who have good emotional health are aware of their thoughts, feelings and behaviours. They have learned healthy ways to cope with the stress and problems that are a normal part of life. They feel good about themselves and have healthy relationships. However, many things that happen in your life can disrupt your emotional health and lead to strong feelings of sadness, stress or anxiety.
•     Here’s a quick review of the emotional map of your brain. Your brain stores and generates emotions in its limbic system, which is the most primitive portion of the brain. The limbic system also contains two other structures called the hypothalamus and the hippocampus. The hippocampus stores dry, unemotional facts for recall, such as where you live and your spouse’s work number. The hypothalamus acts as the commander-in-chief of your hormonal communication system, deciding which gland should release what amounts of hormones at what particular time.

•     The central processing facility for your emotional memories is called the amygdala. If you’re, say, having a heated argument with a driver who just rear-ended your car, the incoming words are filtered through your hippocampus, amygdale, and frontal cortex (the thinking part of the brain) to decide whether or not an appropriate hormonal response needs to be generated by the hypothalamus. Ultimately, your limbic system forms the basis behind the mind-body connection. As you argue with the driver, your heart rate speeds up and you begin to sweat. All of these physiological reactions result from the hormone flow that was initiated by your hypothalamus as a result of emotional distress perceived by your limbic system. This is an extremely simplified explanation of what’s really happening in your brain. So, you can imagine how much more complex your emotional system really is.

•     Today, biochemists are on the verge of understanding how emotions, mediated by hormones, impact the physiological function of our body. If hormones, indeed, play a central role in our psychological well being, then my dietary recommendations should, in theory, lead us to a healthier emotional state as well as to a healthier physiological one.

How can my emotions affect my health?
There is a physical connection between what the mind is thinking and those parts of the brain that control bodily functions. According to Charles Goodstein, MD, clinical professor of psychiatry, New York University School of Medicine in New York City, and president of the Psychoanalytic Association of New York, the brain is intimately connected to our endocrine system, which secretes hormones or chemicals that can have a powerful influence on your emotional health. “Thoughts and feelings as they are generated within the mind [can influence] the outpouring of hormones from the endocrine system, which in effect control much of what goes on within the body,” says Dr. Goodstein.
Your body responds to the way you think, feel and act. This is often called the “mind/body connection.” When you are stressed, anxious or upset, your body tries to tell you that something isn’t right. For example, high blood pressure or a stomach ulcer might develop after a particularly stressful event, such as the death of a loved one. The following can be physical signs that your emotional health is out of balance:
        • Back pain                                                 • Change in appetite                     •Chest pain       
        • Constipation or diarrhea                   • Dry mouth                                       • Extreme tiredness      
        • General aches and pains                   • Headaches                                      • High blood pressure   
        • Insomnia (trouble sleeping)            • Lightheadedness                          • Palpitations (the feeling      • Sexual problems          • Shortness of breath                                                                                           that your heart is racing)
        • Stiff neck                 • Sweating          • Upset stomach                              •Weight gain or loss
Poor emotional health can weaken your body's immune system, making you more likely to get colds and other infections during emotionally difficult times. Also, when you are feeling stressed, anxious or upset, you may not take care of your health as well as you should. You may not feel like exercising, eating nutritious foods or taking medicine that your doctor prescribes. Abuse of alcohol, tobacco or other drugs may also be a sign of poor emotional health.
Stress is nothing but a manifestation of poor emotional skill. Can be defined as Psychological and Physical response to the demands of daily life, that exceed a person’s ability to cope successfully.
Chronic stress from negative attitudes and feelings of helplessness and hopelessness can upset the body's hormone balance and deplete the brain chemicals required for feelings of happiness, as well as have a damaging impact on the immune system. New scientific understandings have also identified the process by which chronic stress can actually decrease our lifespan by shortening our telomeres (the “end caps” of our DNA strands, which play a big role in aging). 
The ancient Roman physician Galen recognized this fact when he commented that depressed women were more prone to breast cancer than their more cheerful counterparts. Depressed individuals have depressed immune systems with abnormally low levels of natural killer cells, lymphocytes, and T-helper cells. This same immune system depression has been observed in individuals who report being chronically stressed or those who have been given a single injection of corticosteroids.
On the opposite extreme of the emotional spectrum is laughter, which is associated with decreased cortisol production and increased production of two types of immune cells, natural killer cells and activated T-cells. This is why Norman Cousin wrote his famous book on laughter as the best medicine against cancer. His theories make perfect sense if you understand the role of eicosanoids and cytokines in cancer. Hormonal messengers, such as cytokines and eicosanoids, mediate the communication between the brain and immune system. The complexity of these interactions is increased because both eicosanoids and cytokines can influence each other. Think of cytokines and eicosanoids as the grammar of the very complex language of emotions. And without the right grammar, every type of language is difficult to understand.
How can I improve my emotional health?
First, try to recognize your emotions and understand why you are having them. Sorting out the causes of sadness, stress and anxiety in your life can help you manage your emotional health. The following are some other helpful tips.
Express your feelings in appropriate ways. If feelings of stress, sadness or anxiety are causing physical problems, keeping these feelings inside can make you feel worse. It’s OK to let your loved ones know when something is bothering you. However, keep in mind that your family and friends may not be able to help you deal with your feelings appropriately. At these times, ask someone outside the situation--such as your family doctor, a counselor or a religious advisor--for advice and support to help you improve your emotional health.
Live a balanced life. Try not to obsess about the problems at work, school or home that lead to negative feelings. This doesn’t mean you have to pretend to be happy when you feel stressed, anxious or upset. It’s important to deal with these negative feelings, but try to focus on the positive things in your life too. You may want to use a journal to keep track of things that make you feel happy or peaceful. Some research has shown that having a positive outlook can improve your quality of life and give your health a boost. You may also need to find ways to let go of some things in your life that make you feel stressed and overwhelmed. Make time for things you enjoy.
Develop resilience. People with resilience are able to cope with stress in a healthy way. Resilience can be learned and strengthened with different strategies. These include having social support, keeping a positive view of yourself, accepting change and keeping things in perspective.
Calm your mind and body. Relaxation methods, such as meditation, are useful ways to bring your emotions into balance. Meditation is a form of guided thought. It can take many forms. For example, you may do it by exercising, stretching or breathing deeply. Ask your family doctor for advice about relaxation methods.
Take care of yourself. To have good emotional health, it’s important to take care of your body by having a regular routine for eating healthy meals, getting enough sleep and exercising to relieve pent-up tension. Avoid overeating and don’t abuse drugs or alcohol. Using drugs or alcohol just causes other problems, such as family and health problems.
The importance of positivity
Scientist Barbara Fredrickson has shown that positive emotions have two important effects: they broaden our perspective of the world (thus inspiring more creativity, wonder, and options), and they build up over time, creating lasting emotional resilience and flourishing. Dr. Fredrickson has spent years researching and publishing the physical and emotional benefits of positivity, including faster recovery from cardiovascular stress, better sleep, fewer colds, and a greater sense of overall happiness. The good news is not only that positive attitudes—such as playfulness, gratitude, awe, love, interest, serenity, and feeling connected to others—have a direct impact on health and wellbeing, but that we can develop them ourselves with practice.
Forgiveness
The attitude of forgiveness—fully accepting that a negative circumstance has occurred and relinquishing negative feelings surrounding the event—can be learned and can lead us to experience better mental, emotional and physical health. The Stanford Forgiveness Project trained 260 adults in forgiveness in a 6-week course.

  • 70% reported a decrease in their feelings of hurt
  • 13% experienced reduced anger
  • 27% experienced fewer physical complaints (for ex: pain, gastrointestinal upset, dizziness, etc.)

The practice of forgiveness has also been linked to better immune function and a longer lifespan. Other studies have shown that forgiveness has more than just a metaphorical effect on the heart: it can actually lower our blood pressure and improve cardiovascular health as well.

Gratitude
Acknowledging the good aspects of life and giving thanks have a powerful impact on emotional wellbeing. In a landmark study, people who were asked to count their blessings felt happier, exercised more, had fewer physical complaints, and slept better than those who created lists of hassles.
Brené Brown has found that there is a relationship between joy and gratitude, but with a surprising twist: it’s not joy that makes us grateful, but gratitude that makes us joyful. 

Mind body intervention and emotional states
All mind body interventions help to return to homeostasis to reverse the effect of the stress.  Mind body interventions respond to engage the parasympathetic nervous system to alleviate the symptoms of stress. Every mind body intervention engages one or more of the five senses. Sight (visualization), Sound (music therapy),  Taste (comfort foods), Smell (aroma therapy) and Touch (muscle massage). 


What mind body interventions can do for my emotions?
Meditation or Mindfulness affects brain cells specifically in our limbic nervous system (base of brain), which controls: Metabolism, Blood pressure, Respiration, Heart rate and Our emotions. Endorphins and Encephalins (pleasure giving hormones) are secreted.
Studies have proven that Migraine headache sufferer experience a 32% reduction in frequency or severity of migraine in practitioners of meditation.

Psoriasis lesions heal 4 times faster with ultraviolet photo therapy along with meditation.
  • Chronic pain relaxation techniques are very effective in lessening the suffering.
  • Cancer treatment: Meditation alleviates the suffering of chronic pain and allows people undergoing chemo to better manage pain and side effects.
  • In surgery:  Prior to it, meditation and relaxation leads to lesser anxiety, patients blood pressure is lowered, they bleed less and surgery takes less time. Current paradigm shift from   biomedical to   biopsychosocial / mind-body model of medicine.
  • Neuroscientist who discovered the opiate receptor leader in research on the role of neuropeptides in the immune system Psychoneuroimmunology: Study of communication interface among emotions, neuroendocrine  thoughts and immune  perceptions systems at the biochemical level.

Kabat zi nn J  devised an outpatient programme in behavioural medicine for chronic pain patients on the practice of mindfulness. 10 wks stress reduction programme focused on detached observation. 51 chronic pain patients who had not improved with traditional medicine care (Pain categories low back, neck shoulders and headache, facial pain, angina pectoris. Non coronary chest pain GI pain) were also represented. Majority of primary care patients complaints lie in a twilight zone between body and mind marked by overlapping psychosocial stress, physical discomfort, relationship conflict, life stage dissatisfaction and unfulfilled aspirations.
In the early 1970s, Herbert Benson, a cardiologist interested in non-pharmacological approaches to hypertension, identified the “relaxation response”. Benson found that meditation was related to Lower heart and respiratory rates Lower-than-average blood pressure. Alpha waves indicating a state of relaxed alertness versus a sleep state. General reversal of the sympathetic activation seen in the “stress response.”

Conclusion:
Emotion plays a pivotal role in sustaining health. Their role needs to be recognized at larger platform including modern medicine. There are many ways to keep your emotional barometer towards positive sides. Mind body interventions are one of them. Mind body interventions could be used extensively by all health practitioners for better patient outcome.

References:

  • Tibbits, D., Ellis, G., Piramelli, C., Luskin, F., Lukman, R. (2006). Hypertension reduction through forgiveness training. The Journal of Pastoral Care & Counseling; 60(1-2):27-34.
  • Toussaint, L.L., Owen, A.D., Cheadle, A. (2012). Forgive to live: forgiveness, health, and longevity. Journal of Behavioral Medicine; 35(4):375-86.
  • Wood, A.M., Froh, J.J., Geraghty, A.W. (2010). Gratitude and well-being: a review and theoretical integration. Clinical Psychology Review; 30(7): 890-905.
  • Worthington, E. L., Jr., Witvliet, C. V. O., Pietrini, P., & Miller, A. J. (2007). Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. Journal of Behavioral Medicine, 30, 291

*Dr. Ranjan Choudhary (Solanki) is working as Assistant Professor, Dept of Community Medicine, MGIMS. Her areas of interest are mind body medicine, integrated healing model and public health management. She researched on issues related to better understanding of mental health and emotional intelligence and their association with physical health. She has organized Breathe life workshop on stress management, emotional intelligence and communication skill for medical and nursing students. She is closely associated with all activities at Arogyadham, Centre for Rejuvenation & Promotion of Positive Health.

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