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Friday, 20 April 2018

Exploring The Mind-Body Connection: Mood As Medicine - by Dr Lauren MacDonald

This week's blog post is by Dr Lauren MacDonald, stage IV cancer survivor who has been NED for over a year. In line with Stress Awareness Month, Lauren shares with us her exploration with the mind-body connection. 



I’ve always been fascinated by the mind, it’s what led me to study Psychology before eventually going on to study Medicine. However, during neither of my degrees did I really consider the enormity of the overlap in the two subjects – namely, that the mind has the power to help heal the body, but also make it physically diseased in the first place. I guess this is because western medicine was traditionally shaped by systems of thought that emphasised the opposite – that the mind and body are separate entities. Yet it now seems so blindingly obvious that they are in fact deeply entwined. The emerging field of psychoneuroimmunology (“psycho” for psychology; “neuro” for neurology, or nervous system; and “immunology” for immunity) is finally providing scientific support for this idea. On a personal level, I also feel as though I’ve had first-hand experience of psychoneuroimmunology via my own cancer journey.

Introducing The Mind-Body Connection

A growing body of scientific research suggests that our mind can play an important role in healing our body, as well as help us to stay healthy in the first place. Recent research has examined how emotions impact our physiology and, as you might expect, emotions such as chronic stress, loneliness, and sadness have been found to cause inflammation, hormone imbalances, impaired immunity, high blood pressure, and illnesses ranging from heart disease and cancer, to anxiety and depression. Conversely, states of calmness, mindfulness and happiness have profound positive benefits, from improved sleep and energy, to better cancer survival rates, and longer telomeres (the end pieces of DNA that shorten as we age).
Although I don’t buy into the idea that the mind can cure the body of cancer simply with positive thinking (this is something I’ve seen peddled on various cancer forums and which actually makes me really angry because it suggests the countless number of people who’ve died from this disease somehow failed to think positively enough), I do now recognise there is a significant role for thoughts and emotions in recovering from illness and preventing disease.

Stress And Cancer

I’ve always felt that I developed cancer at such a young age (and with no family history) due to experiencing two years of chronic stress prior to my diagnosis. I went through two messy relationship break-ups during that time, had to move out of my house, sofa-surfed with friends whilst revising for my medical school finals, moved into a new house with a bunch of strangers from Gumtree, and started work as a junior doctor on a busy ward. After years of flooding my body with the stress hormones cortisol and adrenaline, I was permanently exhausted, and likely put my body at risk of developing cancer. Of course, this can be debated and I’ll never know whether the chronic stress I experienced did contribute to my disease, but there is increasing scientific evidence supporting this idea.
When a person is exposed to a stressful event, their sympathetic nervous system – the system responsible for the ‘fight-or-flight’ response – is triggered, in turn increasing production of a molecule called nuclear factor kappa B (NF-kB) which regulates how our genes are expressed. NF-kB translates stress by activating genes to produce proteins called cytokines that cause inflammation at cellular level – a reaction that is useful as a short-lived fight-or-flight reaction, but if persistent leads to a higher risk of cancer, accelerated aging and disorders like depression.

The Placebo Effect: An Example Of The Mind-Body Connection

When it comes to learning about the mind-body connection and its relationship to our health, it can be difficult to choose a starting place amongst the vast and growing body of research. However, one of the best places to start is probably with the placebo effect. The placebo effect is fascinating because it unlocks the power of the mind; the biological changes observed in the body after administration of a placebo (for example a pill containing no active drug) are not triggered by the placebo itself, but rather by our mind, and our psychological response to these “fake” treatments.
The power of the placebo can be traced back to a landmark study by the late psychologist Robert Ader in the 1970’s. Ader was trying to condition taste-aversion in rats. He’d give them a saccharine drink and, at the same time, inject them with Cytoxan, a drug that suppresses the immune system, but also makes you feel sick. And it worked. The rats learned to hate the sweet drink, which they linked with nausea. Yet, when Ader kept forcing the rats to drink it, they experienced something worse than a mere distaste for saccharine. They started dropping dead, one by one. The reason? Their immune system had “learned” to fail by repeated pairing of the drink with the cytotoxic drug. Incredibly, the drink alone turned off their immunity and they succumbed to infection.
It also turns out that the placebo effect is more powerful than was once thought. In June 2017 a review of five studies, involving 260 patients, found that “open-label” placebos – those that patients know contain no active medication – can improve symptoms in a wide range of conditions.

Healing The Body By Utilising The Mind

It makes sense that if the mind can contribute to making the body sick, it can likely also support its healing. This idea is perhaps best illustrated by the emerging scientific evidence which has examined the impact mind-body activities like yoga and meditation have on human physiology. Eastern traditions of healing (Traditional Chinese Medicine originating in China, and Ayurvedic Medicine from India) have been focussed on this idea for more than 3,000 years.
Interestingly, research has revealed that people who practice activities which originated from these eastern healing systems often show a decrease in production of NF-kB and cytokines, leading to a reversal of the pro-inflammatory gene expression pattern and a reduction in the risk of inflammation-related diseases and conditions.
More needs to be done to understand these effects in greater depth, for example how they compare with other healthy interventions like exercise or nutrition. But this research provides an important foundation to build on to help future researchers explore the benefits of mind-body activities.

Self-Healing

Leading on from this idea, I just want to take a moment to reiterate that I am in no way suggesting that it is possible to heal yourself from cancer by channelling some kind of cosmic energy through the mind! Self-healing with regards to cancer in particular, is an incredibly controversial idea and one that as doctor I don’t believe is plausible. Many people with cancer or incurable diseases are made to feel like failures because they eat well, meditate, believe in God or divine energy, but yet can’t heal themselves. Ultimately some diseases are terminal, no matter what you think or feel. In these cases, traditional medicine (surgery, drugs or radiotherapy) provide the only potential chance of recovery, or at least a prolonged survival.

The Future Of Mind-Body Medicine

Aside from cancer, there are plenty of conditions which I believe can be healed, or even cured, by utilising the power of the mind. Non-traditional healing methods are slowly gaining acceptance within the medical world and there is finally more research being done in this area. Whereas meditation was once considered by doctors to be “mumbo jumbo”, opinion has shifted and people now understand its benefits, the science, and how it can empower patients to be active participants in their healing.
Ultimately the emerging field of Mind-Body Medicine emphasises an individuals whole being, acknowledging that emotional, mental, social, and spiritual dimensions are all important factors in wellbeing, health and healing. However, more research needs to be carried out in this area to enable medical professionals to guide patients towards potentially helpful adjunct healing modalities – rather than leaving patients to be drawn towards expensive, alternative “cures”.
In the meantime I highly recommend any activities which calm the mind, lower cortisol levels, and (hopefully) enable the body to do what its equipped to do; heal. Check out these posts for some ideas:

On Saturday 12th May the Yes to Life spring conference will be taking place in the China Exchange in central London entitled 'Mind your body - The vital role of the mind and the spirit in recovery and wellbeing'. It will involve talks from influential speakers in the day and practical workshops in the afternoon. 

Find out more here.

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