The Road to Relaxation

old man

Last week in clinic, I sat with a man in his ’80’s who I have been treating for anxiety and depression for the past year. He shared with me that he was once a high functioning executive and his life changed dramatically after his wife suffered a stroke. It led him on a downward spiral to insomnia, panic, grief, loss, hopelessness and loneliness. It triggered an intense fear of death and dying and he has trouble leaving the house or engaging in social activities.

It is natural to have feelings of loss, grief and sadness. A stressful event may cause feelings of panic or anxiety with rumination and worry. It is easy to get stuck in this place of worry, perseveration, re-living past events, leading to a path of months or years of depression and anxiety. As part of a holistic approach, I often recommend evidence-based relaxation techniques to help restore balance in the system. I hope they can be helpful to those who suffer from anxiety and depression.

  1. Breathing Exercises – There are many techniques that work to bring attention to our breath. It creates an awareness of our bodies and tethers our minds to our physical beings for the moment. When we focus on our breathing, slow our breath with intention, we down regulate the stress chemicals that make us anxious or depressed. Find a quiet spot, start by sitting in a relaxed position, observe your breath without trying to control it. You may place one hand on your chest and the other on the abdomen to appreciate the rise and fall. You can remind yourself with something as simple as “breath-in, breath-out”. I often teach children finger breathing, trace the fingers of one hand with the index finger of the other hand as you breath in and out. And I also teach a technique called 4-7-8 where you breath in through your nose for a count of 4, hold for a count of 7 and exhale through your mouth for a count of 8 to induce relaxation. When your exhalation is longer than your inhalation, you are activating the relaxation pathways that message your body to rest and digest. This changes the conversation in your body and decreases cortisol and adrenaline levels and infuses your system with happy, calm signals.
  2. Meditation – There are many misconceptions about this word as some incorrectly associate it with ritual or religious beliefs. Think of it as a technique to clear the stress from your mind. Meditation is simply the act of inward concentration. Taking the wandering mind and redirecting it to the inner workings of your body. Whether you concentrate on your breath, your heart beat, relaxing your muscles, or you repeat a phrase that brings you peace or calms your mind, they all work and are considered meditation. It is difficult for most people to sit still and keep their mind from wandering to the past or future events. Guided meditation websites, CDs and apps can help lead those seeking assistance with their practice. Apps like Calm, Headspace, Insight Timer, and Stop Breath Think are very easy to follow and have become immensely popular. My recommendation is to work up to a 20 minute twice daily meditation practice to help reverse the inflammation caused by the toxicity of stress on our systems. Think of it as a mind re-boot. In addition to lowering anxiety and depression, studies show that meditation helps lower blood pressure, risk of heart disease and stroke.
  3. Progressive Muscle Relaxation- A wonderful technique to use at night to settle the restless mind. As you lay in bed, find a relaxed position, and close your eyes if you feel comfortable. Now, feel your toes. Appreciate the sensations, whether they feel tingly, numb or cold. Now curl your toes and tighten your muscles, take a deep breath, relax your toes and breath out. Next move up to your calves, then your thighs, abdomen, shoulders, hands, face, taking one part at a time, tightening the muscles, breathing in and then relaxing the muscles and breathing out. This exercise is excellent when the mind needs to quiet down and the body needs to relax and sleep.
  4. Guided Imagery Exercise- Redirection of the mind to a happier place can help decrease our stress response. Children and artistic people with an active imagination find this technique to be easy and beneficial. Taking your mind to a pleasant experience, like a visit to the beach. Find a quiet spot, close your eyes and then transport yourself to this place. Experiencing it with all your senses; feel of the hot sand, sound of the breezy ocean, taste of the salty air, seeing the waves crash across the shore with the cool, blue water washing over your toes. Allowing for the mind to enter a quieter level without the busy chatter that drives tension and stress. This is a beneficial technique for those who have trouble resting at night.

Relaxation techniques such as the ones mentioned above are only a few suggestions. Any other methods whether it is music, dance, massage, pet therapy, spirituality, exercise, art therapy, social connections, nature walks can all work to restore balance in the brain. Start treating any imbalance with nutrition, exercise, sleep, and mind-body work. It is also important to seek proper mental health and medical professional care in treating serious conditions. It is my belief that true health is obtained by taking the middle road, bridging Eastern and Western medicine.

The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained and board certified in Integrative Medicine. 
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

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