Humans are hardwired to crave certainty. Psychologists argue that it’s an innate need, programmed into our biology and reinforced through evolution.https://www.sciencedirect.com/science/article/pii/S0301008217300369‘>2 https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00243/full‘>4 When it persists, uncertainty becomes a form of chronic stress. I don’t have to tell you how that erodes every dimension of health. It also sucks up valuable mental resources as our brain seeks to resolve the uncertainty.
That’s bad news in times like these. The usual advice applies: practice self-care, gratitude, mindfulness, radical acceptance. But coping with times like these isn’t a matter of mere self-care, not in the way the term gets thrown around. Don’t get me wrong, I’m a fan of bubble baths, chamomile tea, and gentle movement. When it comes to self-care, those are the basics, the bare minimum of kindness we should all be showing ourselves regularly. They’re important, but when our sense of certainty and control have been upended, it takes more than the basics.
Allow Yourself to Feel Your Feelings…
Uncertainty and lack of control have real consequences for our psychological and physical health. Suppressing emotions, denying how challenging the situation is, or engaging in self-recrimination only compounds the problem.
Especially now, when everyone is in the same boat, it’s tempting to downplay our feelings. There’s no need to compare your suffering to others’. There’s always someone who has it worse than you, but that doesn’t mean your feelings are valid. On the contrary, if you’re struggling right now, your feelings are absolutely valid. Your fundamental needs aren’t being met, and you may be dealing with legitimate fears about safety and wellbeing. Many of us are experiencing some form of ambiguous loss, as our ability to engage in “normal life” has been stripped.
…But Avoid Spiraling
It’s one thing to process how hard the current situation is. It’s another to give in to catastrophic thinking.
This is where self-compassion, gratitude, and acceptance practices can help. Together, they allow you to recognize your suffering (to use self-compassion language) while also keeping some perspective. You might also work on both-and thinking, which is a coping strategy from the ambiguous loss literature. Both-and statements acknowledge that multiple, even seemingly contradictory, things can be true simultaneously. Examples might include, “I can feel grief and despair, and also hope,” or “I am less productive than I used to be, and I’m also continuing to make progress.” (More on that shortly.)
When feelings feel too big or too hard, it’s helpful to process them with someone else. Remember, therapy is self-care. One positive outcome of the pandemic is that it’s easier than ever to access mental health services from the privacy of your home.
Melt stress away with Adaptogenic Calm
Lean on Other People…
Resilience is the ability to withstand adversity, trauma, or stress—bending but not breaking, ideally becoming better adapted to face difficult situations in the future. One fundamental source of resilience is having others upon whom you can rely, people who will share your burden and help you get through difficult times.
This doesn’t mean you have to have a large circle of close friends and acquaintances. Rather, it means fostering meaningful and supportive relationships with individuals and/or belonging to groups that provide similar benefits. These might be religious affiliations, volunteer organizations, support groups, or even your workplace.
Of course, this only works if you are willing to reach out. It can be as simple as showing up for a Zoom happy hour with friends, but also don’t be afraid to request more. In my experience, people want to help. They’re just waiting to be asked.
…And Find Ways to Be There for Others
The flip side of this is allowing other people to lean on you. When things feel out of control, being there for others helps you heal, too, by creating positive energy and purpose.
There are lots of ways to be prosocial. Pick up the phone and call someone. Take one small task off a coworker’s plate, or write them a note of appreciation. Donate money or time to an organization working to affect positive change. Write a letter to your congressperson. Send a care package. The act of giving can actually create energy, so long as you’re careful to balance it with filling your own bucket.
Expect Less of Yourself…
How many think pieces have been written over the past six months giving us permission to be less productive than normal? I guess not enough, because I see lots of people continuing to beat themselves up for struggling at working, being less strict with their exercise routines, and letting their houses be messy.
Clearly, we underestimate how much uncertainty in and of itself drains our mental resources. While we may be over the initial shock of the pandemic—though the hits of 2020 keep on coming—the uncertainty and lack of control remain. Give yourself grace. Allow yourself to rest. Reevaluate your standards for “success.” Say no where you can.
…But Keep Getting Things Done
It’s all well and good to say you should lower your expectations and say no to things, but what about the things you have to get done? Jobs, parenting, and caregiver responsibilities can’t simply be tossed aside. While I do support the idea that it’s ok to do less right now, sometimes you need to buck up and take a step forward (mental health crises excluded).
Action, any action, can be self-reinforcing because you’re exerting control again. Maybe it’s checking the easiest task off your to-do list, taking one small step towards completing a project, or doing five minutes of exercise. Just keep the ball rolling. Do NOT focus on the ways in which your effort or performance is less than what it used to be, but rather that you’re still making an effort in the first place.
Maintain a Focus on Health
Emotional eating, drinking, and laying on the couch all day are completely understandable responses to times like these, but ultimately, they compound the stress. You know how much better you feel when you maintain some semblance of healthy eating, movement, and sleep, or conversely, how crummy it feels when you let it all slide. By and large, these are variables that you can control even when everything else feels like it’s gone to hell.
Again, I’d encourage you to reassess your standards of success here, adjusting to your current reality. It’s ok if you don’t have the wherewithal to make elaborate dinners or train for a 50k. Resist the temptation to let the pendulum swing completely in the other direction, though. Think of each meal as one small act of productivity and each walk as an accomplishment.
Be in Nature
Few things are as inherently healing and soothing as spending time in nature. Research into the practice of forest bathing documents all sorts of benefits from, essentially, going into the forest (or even just a park) and being mindful. A recent study found that taking “awe walks,” which are simply outdoor walks in which you have the specific intention of experiencing awe, lead older adults to experience more positive emotions and less distress.Raise your hand if you’ve been feeling a little overwhelmed. Aside from the fact that being in the middle of a pandemic makes everything more stressful, you’ve got work obligations and family commitments, then there are food choices to make, at-home workouts you think you should be doing, and non-stretchy pants you’re feeling bad for not fitting into.
It’s a lot. I get it, and it’s totally normal to feel overwhelmed. That said, staying in a state of overwhelm is a choice.
Yep, you heard me, it’s a choice. And if you’re ready to get out of the seemingly relentless spin cycle of life (and the tight chest and racing mind that come with it), stick around. I’ll be unpacking the real reason you get overwhelmed — spoiler alert, it’s not because your to-do list is too long — plus, four things you can do to change it.
Why Do I Get Overwhelmed?
I’ll give you an example from my own life. As a health coach, I’ll often hear my clients say that they just can’t do it. They can’t swap out their toast and cereal for breakfast. They can’t make time to get outside. They can’t get to bed earlier. They can’t…fill in the blank.
In my opinion, “I can’t” statements reflect limiting beliefs. They aren’t real; they’re just stories we tell ourselves, and identities we accidentally end up identifying with. It’s not that you can’t, it’s that something is holding you back. I find that most of the time, when I dig a little deeper, that thing is fear.
Types of Fear That Cause Overwhelm:
- Fear you won’t be able to handle it
- Fear of getting it wrong
- Fear you won’t get it done (on time)
- Fear that you’ll be judged
- Fear of the consequences
- Fear of not being in control
- Fear of being embarrassed
- Fear that you don’t really deserve it
Whether you’re experiencing worry, stress, or complete overwhelm, fear is usually at the helm, just FYI. But the goal here isn’t to be fearless (there actually are some benefits to fear),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882379/‘>2 The stress hormones, adrenaline and cortisol flood your system, preparing you to fight or flee. Not only that, the amygdala instantly shuts down the neural pathway to your prefrontal cortex which temporarily impairs all rational thinking, making you feel disorganized and out of control.https://www.marksdailyapple.com/deep-breathing/‘>5 It doesn’t matter what kind of breathing you do — box breathing, alternating nostril breathing, and diaphragmatic breathing all work. Just make sure that the method you choose is rhythmic, meaning that you breathe in and out for about the same amount of time. After a few minutes you’ll notice that your mind has slowed down and your energy is much calmer.
Try this: Here is a triangular breath exercise that I’ve created for my clients. Inhale through your nose, counting slowly to 6; hold for a count of 2 at the top; and exhale for a count of 8. Repeat for 1-3 minutes or until your mind feels calm again.
Check Your Stories
You know the limiting beliefs and thoughts that prevent you from achieving your goals? These are your stories. And I call them stories because they’re just not true. You may have picked them up from things you heard your parents say growing up or from an experience you went through. Maybe you decided along that you always drop the ball. Or that things always feel too big for you, and who were you to achieve big things anyway?! These narratives become a form of identity that not only reflects who we think we are, but also what we think is possible for us.
Try this: Next time you catch yourself doubting your greatness, turn it on its ear. Instead of saying, “I don’t think I can stick to a new way of eating” try “I am fully capable of doing new things.”
Take the Stairstep Approach
When I work with new clients, they often feel overwhelmed by all the things they think they have to do. There’s cleaning out the cabinets, figuring out which brands are canola-free, learning how to make their own bone broth/kombucha/beet kvass… This is about the time I sneak in my stair-stepping approach. This technique is awesome because it breaks the journey down into smaller steps, which is less intimidating than trying to leap to the end in a single bound.
Try this: On a piece of paper, literally draw a staircase. Identify the bottom step (this is where you are now) and then identify the top step (this is where you want to go). Figure out the very first thing you need to do to get to the next step, then do that thing! The rest of the steps will reveal themselves as you go.
Just because you can do all the things, doesn’t mean you need to. A lot of times we get overwhelmed simply because we put too much on our plates. Just like there’s no gold medal for getting more done, there’s no punishment for doing less. Your worthiness has nothing to do with how much you accomplish or don’t accomplish. That being said, there’s also no shame in delegating out tasks and responsibilities.
Try this: Think about what areas of your life could use some assistance. Can your spouse cook up a healthy dinner tonight? Can your kids help you sort through Primal recipes? Make a list of the tasks you want to dole out and if you need help getting more comfortable with asking for help, read this.
Go From “I Can’t” to “I Got This”
Life can be overwhelming, even when you’re not in the middle of a pandemic. But by paying attention to your triggers, your stories, and your breath, you can restore your ability to think, to listen, and move forward. It does take practice, but eventually you can train yourself to respond rather than react. Follow these four steps and see how it works for you:
- Check your Stories
- Take the Stairstep Approach
How do you manage overwhelm? What tactics do you use to move through it or avoid it all together?
The post What it Really Means When You’re Overwhelmed (and 4 Ways to Move Past It) appeared first on Mark’s Daily Apple.
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‘Tis the season for consumption.
Cookies, cakes, and pies abound. Feasts happen on a regular basis. Candy is given and received as gifts. And there are parties immeasurable—at work, with family, with friends—where calorie-dense, rewarding food is handed out, like, well, candy. The holiday season is a practice in overeating, and it can be very hard to avoid. You may not want to even avoid it; there’s something to be said for letting loose now and again on special occasions, especially when holiday cheer is in the air.
But what happens to your body when you overeat? And what can you do about it?
The type of overeating most people do across the holidays is high-sugar, high-fat, and relatively low protein. These are your cakes and cookies. Your brownies and fudge. Your pie for breakfast. This is the worst kind of overfeeding you can do. Research shows that just six days of high-sugar, high-fat, low-protein overfeeding rapidly increases fat deposition in the liver and muscle. Seven days of overfeeding reduces whole body insulin sensitivity, inhibits glucose clearance, and impairs endothelial function.
If you keep doing it, say, over the course of a month, bad things pile up. You get incredibly insulin resistant. Your liver fat increases. Your body weight and overall body fat increase. Your C-reactive protein increases, an indication of inflammation. A class of antioxidants called plasmalogens also increase, which means your body is fighting oxidative stress.
One problem with the studies is that you have to distinguish between quality and quantity; overfeeding with different foods elicits different effects. For instance, in the study that looked at overfeeding’s effect on lipid metabolism, the subjects overate by eating more cookies, potato chips, and cheesecake and drinking an oil-based liquid supplement. Overeating a bunch of that junk food is different than overeating steak.
In fact, research shows that overfeeding protein has little to no impact on fat or weight gain compared to carbohydrate or fat overfeeding.
Another factor to consider is individual variability. Some people are “obesity prone.” Others are “obesity resistant.” In one study, obesity prone and obesity resistant subjects had different responses to three days of overfeeding. The obesity prone people saw their fat oxidation rates drop during sleep; they burned less fat. The obesity resistant subjects saw their fat oxidation rates unchanged during sleep; they continued burning fat like normal.
So, when we talk about the effects of overeating, we have to keep in mind that the effects will differ between individuals and vary if you’re eating a pound of roast lamb versus eating half a pie. But the general point still stands: Overeating can make you gain weight, gain liver weight, induce oxidative stress, cause insulin resistance, increase inflammation, and make you sicker, fatter, and more unwell the longer it goes on.
But am I too late in saying this? Are you already dealing with the effects of excess? Here are 8 tips for scaling back and minimizing damage.
1. Favor Protein
As explained above, overfeeding protein has more neutral metabolic and body composition effects than overfeeding fat and carbs. Some effects are even positive, like boosts to energy expenditure during the day and during sleep. Load up on the turkey, the lamb, the beef rib roast and keep portions of mashed potatoes, pumpkin pie, stuffing, candied chestnuts, and cookies more reasonable. One advantage of overeating protein is that eating less of the other stuff tends to happen inadvertently.
2. Eat Vinegar
Vinegar, whether it’s organic apple cider vinegar with the mother still swimming in it or standard white vinegar from a two gallon jug, improves glucose tolerance and keeps postprandial hyperglycemia and insulin tamped down. The trick is eating the vinegar (maybe a side salad before the big meal dressed with a vinegar-y dressing) 20-30 minutes before you overindulge.
This is most relevant for meals containing carbohydrate.
No, exercising after overeating is not “binge behavior” or evidence of an “eating disorder” for most people. It’s simply physiological common sense. You consume a ton of calories, calories in excess of what your mitochondria can process and convert to energy. What makes more physiological sense—just sitting there, letting that extra energy circulate and eventually accumulate on your body, or creating an energy deficit so that the extra energy is utilized?
This isn’t about “calories,” per se. It’s about throwing a ton of energy toward your mitochondria and giving them a job to do—or letting them languish in disuse. It’s not about “weight gain,” necessarily. It’s about energy excess and the oxidative stress and inflammation that results. It’s about not being wasteful. If you introduce a ton of energy and then do nothing, you are wasting that potential.
Besides, research shows that exercise counteracts the short term negative effects of overfeeding, including countering the negative epigenetic effects seen in the adipose tissue of over-consumers. The best time to exercise is immediately after eating. Of course, I wouldn’t suggest doing an intense CrossFit workout with a belly full of food, but something light like the several sets of 10 pushups, squats, lunges, and situps in this study done immediately after does the trick.
4. Accept It As a Positive Experience and Move On
That overeating induces oxidative stress enough to trigger the release of antioxidant compounds may mean the occasional acute bout of overeating can act as a hormetic stressor that makes you stronger in the long run—provided it stays acute and hormetic. It could actually be good to overeat once in awhile. Yeah, go with that.
5. Have Some Black Tea
I just did a big definitive guide to tea, and it turns out another benefit of the stuff is that it actually speeds up digestion after eating. It beats alcohol, espresso, and everything else that people tell you helps digestion.
6. Go For a Walk
Right after you overeat, a 20-30 minute walk will reduce blood glucose and speed up gastric emptying—helping you process the meal much faster and reducing the feeling of fullness. Longer walks are even better and can also reduce the postprandial insulin spike. It has to be immediately after though; waiting even 30 minutes will suppress the effects.
7. Get Out Into the Cold
It’s the perfect season for cold exposure (in most places). Even mild cold exposure—just 18°C or 64.4°C for 2.5 hours—is enough to increase energy expenditure without increasing hunger or subsequent food intake. That’s downright comfortable for a lot of people. If you went out into sub 50°F weather, I bet you could get the same effects even faster.
8. Don’t Throw In the Towel and Continue Overeating For the Foreseeable Future or “Until the New Year”
A consistent finding in the literature is that people gain weight during the holidays and never quite lose it. They don’t do this because they had an extra slice of pumpkin pie at Thanksgiving or five cookies on Christmas morning. They gain and retain the weight because they consistently overindulge for the entire duration of the holidays. They figure “Oh, I ate badly yesterday, which means this week is shot. I’ll just do better next Monday,” and then keep that mindset going for months.
Well, one way to break that cycle is to stop that “this week/month is shot” mindset. No, just because you ate badly yesterday doesn’t mean you should eat badly today and tomorrow. That will compound your problems and dig an even deeper hole. Stop overeating immediately.
Overeating happens. It’s okay, or even beneficial if used judiciously. There’s nothing like filling your belly with your grandma’s signature dish, or really letting loose with your favorite people in the world. Humans are feasters by nature. We like to make merry and eat big to ring in the good times. Just make sure you contrast it with leaner days. (Intermittent fasting around the holidays is great for this.) A feast no longer qualifies as a feast if you do it consistently. A party’s not a party if you party every day. Contrast is the stuff of life—heed that rule and all will be well.
How do you approach holiday overeating? What do you do to counter the effects? What physical behaviors and mental models do you adhere to? Let me know in the comment board.
Take care, everyone, and happy feasting!
Surowska A, Jegatheesan P, Campos V, et al. Effects of Dietary Protein and Fat Content on Intrahepatocellular and Intramyocellular Lipids during a 6-Day Hypercaloric, High Sucrose Diet: A Randomized Controlled Trial in Normal Weight Healthy Subjects. Nutrients. 2019;11(1)
Parry SA, Turner MC, Woods RM, et al. High-Fat Overfeeding Impairs Peripheral Glucose Metabolism and Muscle Microvascular eNOS Ser1177 Phosphorylation. J Clin Endocrinol Metab. 2020;105(1)
Leaf A, Antonio J. The Effects of Overfeeding on Body Composition: The Role of Macronutrient Composition – A Narrative Review. Int J Exerc Sci. 2017;10(8):1275-1296.
Schmidt SL, Kealey EH, Horton TJ, Vonkaenel S, Bessesen DH. The effects of short-term overfeeding on energy expenditure and nutrient oxidation in obesity-prone and obesity-resistant individuals. Int J Obes (Lond). 2013;37(9):1192-7.
Bray GA, Redman LM, De jonge L, et al. Effect of protein overfeeding on energy expenditure measured in a metabolic chamber. Am J Clin Nutr. 2015;101(3):496-505.
Ostman E, Granfeldt Y, Persson L, Björck I. Vinegar supplementation lowers glucose and insulin responses and increases satiety after a bread meal in healthy subjects. Eur J Clin Nutr. 2005;59(9):983-8.
Solomon TPJ, Tarry E, Hudson CO, Fitt AI, Laye MJ. Immediate post-breakfast physical activity improves interstitial postprandial glycemia: a comparison of different activity-meal timings. Pflugers Arch. 2019;
Heinrich H, Goetze O, Menne D, et al. Effect on gastric function and symptoms of drinking wine, black tea, or schnapps with a Swiss cheese fondue: randomised controlled crossover trial. BMJ. 2010;341:c6731.
The post Post-Binge Biology: What Happens To Your Body When You Overeat (and 8 Things To Do Afterward) appeared first on Mark’s Daily Apple.
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You know how much mindfulness matters in the happiness and connectedness of your everyday life — at home, with your kids, at the office, with your partner, with your friends and family, etc. But did you know that you can help your kids to be more mindful and therefore happier, too — both by how you parent and by exhibiting mindfulness yourself? True story, says Beverly Conyers, mindfulness expert, author of Find Your Light: Practicing Mindfulness to Recover from Anything, and mom to three grown children. In this guest post, she’s going to show us how to start incorporating mindfulness…
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You’ve likely heard a lot about eating mindfully, but maybe you’re short on tangible tips for actually doing it. If so, you’re in luck with today’s guest post from Heather Sears, founder of Kinsho, the go-to bento box brand for creating enlightened eats, and the four-time award-winning author of Mind to Mouth: A Busy Chick’s Guide to Mindful Mealtime Moments. She lives in Boston with her family where she was named a 2018 Trailblazer, and she’s sharing her thoughts on how using a bento box can make a real difference in how you eat your meals. Mindful eating may feel trendy, but researchers…
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The treatment usually prescribed by doctors, hormone therapy (HT), is controversial and not appropriate for some women. I won’t get into the HT debate here—Mark did a great job covering the pros and cons recently. Suffice it to say that HT isn’t the answer for everyone, and it’s not a panacea by any means.
Whether or not they choose to go the HT route, many women desire additional support during perimenopause and beyond. For the sake of keeping this post from becoming a novella, I’m going to focus on mind-body therapies today.
This is not meant to be an exhaustive list of nonhormonal options, nor is it meant to try to dissuade you from trying HT. That’s a decision you have to make for yourself with your doctor. The approaches below can be used alone or in combination with other modalities, including HT.
As with any medical-adjacent tools, if you are considering any of the options here, take the time to educate yourself, talk to your doctor, and find qualified practitioners to help you implement these practices.
A Note Regarding Research Evidence…
Because so many women are interested in complementary or alternative approaches, there’s a fair amount of research into nonhormonal treatments. There are also important limitations.
A lot of the randomized control trials—experiments that are best for establishing causal effects—are small. There is considerable variability in research design, so it’s difficult to generalize across studies.
Participants in these studies tend to be white and well-educated. Since there are cross-cultural differences in the experience of menopause, we shouldn’t assume that the findings apply to all women. Likewise, a lot of the research focuses on women with a history of breast cancer because HT is generally contraindicated in this population. While the results of these studies probably generalize to other women, it would be great to have more data.
Finally, vasomotor symptoms—hot flushes and night sweats—are studied more than other types of symptoms. Though they are the most common complaint, many women do not experience debilitating vasomotor symptoms. They might, however, experience mood fluctuations, depression, sexual issues, memory problems, and more. We know less about how these approaches might help those women.
Nevertheless, I’ll highlight some of the potentially fruitful avenues you might explore. When possible, I’ll focus on systematic reviews and meta-analyses. They pool the results of multiple smaller studies to help a more reliable picture emerge.
Cognitive Behavioral Therapy (CBT)
In CBT, individuals are encouraged to explore how their thoughts (cognitions) affect feelings, behaviors, and physical symptoms. With help, they change their thoughts or beliefs about a situation to help manage their responses and improve coping skills.
Although there isn’t a ton of research on CBT for menopause, available studies are very promising. Whether or not CBT reduces the actual number of hot flushes—and the data here are mixed—CBT should work by changing women’s perceptions of their hot flushes. Multiple studies do find that after CBT women view their hot flushes as interfering less with daily life. As expected, they are also less bothered by them.
Women who see themselves as having less control over their hot flushes also tend to experience more distress. Changing their perceived control could be an effective intervention for improving quality of life. Indeed, in one study, 95 women received either group-based or self-help CBT. After therapy they reported feeling greater control over hot flushes and having better coping skills compared to women in a no-CBT control condition. Further analyses showed that women’s beliefs about control and coping predicted how problematic they found their hot flushes to be. (Having more positive beliefs about how hot flushes affect sleep also helped.)
Women who participated in CBT also experienced fewer sleep issues and insomnia as well as fewer depressive symptoms and sexual concerns. They also noticed less impairment at work. Positive results were found with in-person therapy, self-help programs, and telephone-based therapy. When studies included a follow-up assessment, the beneficial effects of CBT persisted for at least six months.
Mindfulness, Meditation and Relaxation Training
A cross-sectional study of 1744 women found that women with higher scores on a mindfulness assessment tended to report less severe menopausal symptoms. For women with higher life stress, this association was especially strong. The idea here is that when women are able to be present-focused and observe their symptoms without judgment, they are protected against some of the distress, and possibly the physical symptoms, associated with menopause.
Although some of the women in that survey are probably mindful by nature—lucky them—mindfulness is also a skill that can be learned and cultivated. Among the many reasons to do so, mindfulness and meditation training can apparently lessen menopausal symptoms.
For example, researchers assigned 110 women to either an intensive eight-week mindfulness-based stress reduction program or a control group. The women who received mindfulness training reported having less bothersome hot flushes, better sleep quality, less anxiety and stress, and greater overall quality of life compared to the control group. When the researchers followed participants over the next 11 weeks, these results persisted or became even stronger.
A few other studies found that women who receive mindfulness or meditation training report fewer and less bothersome hot flushes, improved sleep, and better psychological functioning, though the results have not consistently endured over time. However, when looking at more general relaxation training and paced breathing techniques, effects are minimal, at least for hot flushes.
An ethnographic study of nine female yogi masters concluded that they tend to skate fairly easily through menopause. The authors concluded that menopausal women should be encouraged to practice yoga. Of course, in addition to yoga, these yogi masters’ lifestyles included “healthy food habits, adequate sleep, and the use of nature cure techniques (i.e., fasting, detoxification, selection of suitable food products, and living in well-ventilated houses) that facilitated the art of living in tune with nature.” This sounds pretty great, but can we give really yoga all the credit here?
Probably not. However, two recent meta-analyses did conclude that yoga offers small but significant relief from symptoms of all types: vasomotor, psychological (including depression), somatic (including fatigue and sleep disturbances), and urogenital. Women also report better overall well-being and quality of life after receiving yoga training.
In one study, a group of breast cancer survivors received twelve weeks of yoga and meditation instruction, and they were encouraged to practice daily at home. Compared to women in a control group (no instruction), they reported fewer symptoms and improved quality of life at the end of the twelve weeks and again when asked three months later. A later analysis found that many of the effects were mediated by improved self-esteem in the yoga group.
Note that most of the individual studies are small, and they employ different types of yoga practices. This might be considered a strength insofar as different practices have been shown to work, or a weakness in that it’s not clear if one approach is particularly effective.
Cross-cultural surveys find that women who are more active tend to have an easier time with menopause. For example, two large surveys of Swedish women found that women who exercised at least once per week reported less intrusive symptoms than women who never exercised, and women who exercised more than three hours per week were significantly less likely to experience severe symptoms than their less active counterparts. Sedentary women in this Finnish study experienced more vasomotor, psychological, and somatic/pain symptoms than women who were at least somewhat active.
While promising, experimental studies have not yielded such favorable results. When women were assigned to “physical activity” conditions (often walking), some studies report improvements, but others find no improvements or even worsening symptoms (perhaps depending on women’s baseline fitness). Multiple reviews have concluded that there is no systematic effect of exercise, particularly not for vasomotor symptoms.
Does that mean menopausal women shouldn’t exercise? Obviously no. It’s clear that being active—or at least not being sedentary—is important for overall health, and it probably helps menopausal women through the transition. However, there isn’t enough research to know what types of exercise are most effective and when. Do the types of movement you enjoy and that make your body feel good.
A recent review concluded that acupuncture is effective for reducing vasomotor symptoms, both frequency and severity, as well as for improving quality of life. However, the reviewers also found that acupuncture was not reliably better than sham acupuncture where needles are inserted at points other than the prescribed pressure points and at a shallower depth—a placebo condition.
A handful of studies have shown that clinical hypnosis can reduce hot flush frequency and distress among breast cancer patients. Another study of 187 women without breast cancer found that women who received hypnotherapy had fewer, less severe, and less bothersome hot flashes, as well as improved sleep. These results were evident at the end of the five-week treatment protocol, and they remained or got stronger in the six-week follow-up period.
The Experts Weigh In…
In 2015, the North American Menopause Society released a position statement on nonhormonal management of vasomotor symptoms. Of the approaches discussed here, the only ones NAMS recommended based on the strength of the available evidence were CBT and hypnosis. Mindfulness-based stress reduction earned a “recommend with caution,” which means, “We think it might work, but the evidence isn’t conclusive.”
The others—yoga, exercise, relaxation and paced breathing techniques, and acupuncture—were not recommended. This does not mean they are not worth trying! It simply means that based on their standards, the evidence was not strong enough for the committee to conclude that they are likely to be effective treatments for vasomotor symptoms specifically. This says nothing about other types of symptoms, nor about general well-being or quality of life.
Mind-Body Therapy Pros and Cons
So where does this leave us? Each of these therapies shows promise for alleviating at least some symptoms of menopause. Moreover, all these therapies have the potential to improve overall quality of life, sleep, stress, and general health. While reading these studies, I did wonder whether some of the women felt better simply because they were investing time and energy in taking care of themselves. If so, is that a problem? I don’t think so. They are low-risk interventions with a lot of potential upside.
That said, these aren’t quick solutions. The effective mindfulness/mediation trainings included six to eight weeks of classes and multiple hours per week. Women practiced yoga for two to four months during the study periods. Hypnotherapy was five weeks or longer. It’s not clear what the minimum time frame is for each of these therapies to be useful, but they’ll certainly involve a time commitment that might not be practical for all women. However, yoga, mindfulness/meditation, exercise, and even CBT can all be practiced at home once you know the proper technique.
As I said at the beginning, this is not an exhaustive list of nonhormonal therapies. There are also various supplements that might help, as well as lifestyle modifications that most of you Primal-savvy readers are probably already implementing: eating a variety of nutrient-dense foods, getting plenty of sunlight, practicing good sleep hygiene, and nurturing social connections.
Whatever you choose, be patient. Don’t just focus on one symptom; focus on the big picture. Pay attention to how you’re feeling more globally. Consider that while an intervention might not hit its desired mark, it might help you in ways you didn’t expect.
Have you used mind-body techniques (these or others)? What’s been your experience? Share your insights and questions below, and have a great week, everyone.
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