I recently worked with a most excellent medical student, Karinne Van Groningen. She is the kind of student that practicing physicians love to work with: enthusiastic, bright, and a self-starter. During her rotation with us, she chose a topic and wrote a guest post featured below:

“Good morning my Karina!”

That was the typical greeting I got from one of my patients during my rotation on the Hematology-Oncology service at Washington Hospital Center as a third year medical student. Ms. S was a vibrant woman with AIDS and newly diagnosed lymphoma. Her prognosis was poor — at the time of diagnosis the cancer had spread throughout her body. I made it a point to stop by her room throughout the day and met a handful of her family and friends. We shared stories of our backgrounds and plans for the future. One afternoon, before leaving the hospital, I stopped by her room to say goodbye. She wasn’t her normal bright self; she didn’t instantly give me her warm smile or call out her nickname for me, “Karina.” Instead, she moved around her IV cords and looked at me with a somber face. She leaned in and said, “I just wish I were like you, able to get out of bed and walk around…. I just wish I could have my health back.”

Earlier that morning, I wanted nothing more than to lie in bed and get more sleep. The thought hadn’t crossed my mind that I was, in fact, incredibly lucky to be able to get out of bed, round on patients, and meet people like Ms. S. This happens to all of us. On so many days we’re tired, rushing from point A to B, preoccupied with what’s to come, oblivious to the subtleties of our environment. It’s rare that we stop during our busy days to notice our surroundings, acknowledge our gratitude for the blessings in our lives, or take time to breathe. But considering the many ways that practicing mindfulness has been shown to improve health, maybe we should.

What is mindfulness? It has been described as the practice of purposeful, nonjudgmental attention to the events of the present moment. It is incredibly easy to practice, and takes virtually no time. For example, the next time you’re outside, think about how the cold air feels on your face. When you take your next bite of food, notice the texture and the taste you sense. Upon waking up in the morning, try to list three things you’re thankful for. These simple mindfulness exercises could improve your health, and here’s how:

It lowers stress: A UC Davis study found that mindfulness can lower levels of cortisol, a substance released by our body in response to stress, which at high levels has been associated with hypertension, bone loss, and hyperglycemia. The study sent 57 people to a 3-month retreat where they practiced compassion, meditation, and mindful breathing. Their saliva cortisol levels were measured both before and after the retreat. After the retreat, participants were less stressed, had an increased propensity to let go of distressing thoughts, and had decreased levels of evening cortisol associated with reported increases in mindfulness.

It makes us more compassionate: Harvard and Northeastern University researchers showed that mindful meditation can improve compassion and do-good behavior. They divided participants into two groups: one group underwent 3 weeks of mindfulness meditation online self-study, and the active control group underwent a 3-week online cognitive skills self-study. At the end of the training period, participants were placed in a staged waiting room with only one empty chair left, and were asked to take a seat. Then an actor, appearing to be in great distress, entered the room with a set of crutches. In the control group, only 14% of people got up and offered the pained person his or her chair. In the meditation group this number increased to 37%. This supported previous findings by the same group in which 50% of the meditation group gave up their seats compared to 15% in the control group. It appears that mindfulness made participants more willing to act altruistically and help another in need.

It’s good for our hearts: A study in April 2015 found that gratefulness can lower inflammatory biomarkers associated with adverse cardiovascular events. The study involved 186 men and women who had longstanding cardiac disease. Patients were asked to complete a questionnaire that would measure their level of gratefulness. They found that patients who were, at baseline, more grateful, had lower levels of inflammatory biomarkers that predispose a patient to adverse outcomes. The more grateful patients also had better sleep, less fatigue, and less depressed mood. The same researchers then conducted a follow-up study to further look at the beneficial effects of gratefulness on cardiac health. They asked 40 patients with heart disease to write down three things they were grateful for on most days of the week for 8 weeks. At the end of the trial researchers found that patients who kept a gratitude journal showed reduced levels of inflammatory biomarkers and had an improved heart rate variability, which is associated with reduced cardiac risk.

It helps us view ourselves more positively: A 2012 study published in Frontiers in Human Neuroscience found that mindfulness-based stress reduction techniques can lead us to view ourselves more positively. The study analyzed 56 patients with social anxiety who were randomly divided into two groups: one that focused on mindfulness-based stress reduction through yoga and meditation, and another that focused on aerobic exercise. After 8 weeks, the group that practiced mindfulness had a greater decrease in negative self-views, an equivalent increase in positive self-views, and decreased social anxiety as compared to the aerobic exercise group.

It can improve overall quality of life: A January 2016 study published in Pediatrics studied the utility of mindfulness exercises in socioeconomically marginalized urban youth. Researches took 300 students in fifth through eighth grades from Baltimore urban elementary and middle schools and divided them into two groups. The experimental group underwent a 12-week mindfulness program that consisted of didactic sessions in yoga and meditation, group and individual practice of meditation and yoga, and group discussion focused on the application of mindfulness activities. The control group underwent a general health program that covered topics such as nutrition, exercise, and puberty. At the end of the study, those in the mindfulness group reported lower levels of depressive symptoms, self-hostility, negative affect, negative coping, and rumination. The mindfulness participants also showed significantly lower levels of posttraumatic stress symptoms.

A wealth of recent evidence strongly suggests that practicing mindfulness can improve both physical and mental health. Better yet, there are zero known side effects of this practice. So the next time you get a chance, why not take a minute to take a deep breath, give thanks, and observe where you are in the moment?

And while we definitely encourage joining mindfulness programs or reading books on the topic, we want to add a few simple techniques that are easy to add to your daily life. They can even be taught to children. These ideas are from The Mayo Clinic’s Guide to Stress Free Living:

Every morning, think of five people with whom you can share your gratitude. Instead of letting your mind think about what needs to get done or if you are late or what you should wear, let your first thoughts be Thank Yous for the people who make your life greater. This could be your friends, partner, parents, neighbors, teachers, children, or pets.

 Involve children. Tell your children or your nieces and nephews that you are thankful for them. Allow them to enjoy the practice of gratitude. They can give thanks with you (my kids practice gratitude at bedtime nightly. I was surprised when my 2 year old started chiming in along with his older sister. He started naming people he enjoys in his life… as early as age 2, kids can pick up on and participate in the circulating theme). You can also allow kids to deliver Thank You cards to a friend or teacher (or doctor!). This leaves a lasting positive effect on children.

Look at the bright side. This sounds easy but it can be difficult. Choosing to look at circumstances from the positive perspective can strain the mind. Mundane examples include paying taxes (hey, you earned money) or having to take care of your yard (hey, you have a home). But you can see how this is more difficult in heavier situations like personal illness or illness in a loved one (focusing on what you do have, rather than what the illness has taken from you). Regular practice can make this an automatic part of your overall attitude and view on life.

Keep a gratitude journal. Write down things (or one thing) that you are grateful for at the end of the day (or week). My husband and I keep a shared journal. On rough days when one or both of us needs a little reminder, we can look back on some of our entries and remember fun(ny) experiences or quotes from our kids or loved ones.

References:

1. Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Dell Publishing; 1990
2. Jacobs, T.L., Shaver, P.R., Zanesco, A.P., et al. Self-reported mindfulness and cortisol during a shamatha meditation retreat. Health Psychol. 2013;32(10)1104-1109.
3. Condon, P., Desbordes, G., Miller, and W., DeSteno, D. Meditation increases compassionate responses to suffering. Psychological Science. 2013;24:2125-2127
4. Mills, P., Chopra, D., Redwine, L., et al. The role of gratitude in spiritual well-being in asymptomatic heart failure patients. Spiritual in Clin Pract. 2015;2(1)5-17.
5. Goldin, P., Ziv, M., Jazaieri, H., and Gross, J.J. Randomized controlled trial of mindfulness-based stress reduction versus aerobic exercise: effects on the self-referential brain network in social anxiety disorder. Font Hum Neurosci. 2012;(6)295
6. Sibinga, E., Webb, L., Ghazarin, S.R., and Ellen, J.M. School-based mindfulness instruction: an RTC. Pediatrics. 2016;137(1):1-8.