Tips and tricks to help doctors de-stress

Naveed Saleh, MD, MS, for MDLinx | November 07, 2018

Stress is a reality for all people and a normal part of everyday life. But undue stress can trigger or worsen physical and mental health conditions.

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doctors doing yoga

Relaxation techniques, such as deep breathing, guided imagery, and progressive relaxation, can help physicians better cope with stress and anxiety.

Physicians, in particular, face such stressors as long workdays, high caseloads, time pressures, shift work, high performance expectations, poor sleep habits, personal fears about competency, and changing roles in the workplace. In addition, physicians regularly deal with suffering, fear, pain, and death, as well as challenging interactions with patients, families, and other medical personnel.

Indeed, a survey of general practitioners in the United Kingdom revealed that 13.4% reported troublesome depression, 31.1% said they had excessive anxiety, 46.7% had sleep difficulties, and 61.7% reported exhaustion and stress.

Relaxation techniques can be used to combat the effects of stress and ease tension. The National Institutes of Health (NIH) National Center for Complementary and Integrative Health (NCCIH) took a closer look at different types of relaxation techniques and evidence for their potential health benefits.

Different relaxation techniques

Relaxation techniques induce the body’s natural relaxation response, which is marked by slower breathing, lower blood pressure, and increased well-being. They often mix breathing and focused attention on pleasant thoughts and images to relax the mind and the body.

The following are six examples of relaxation techniques.

  1. Autogenic training involves focusing physical sensations of warmth, heaviness, and relaxation in different parts of the body.
  2. Biofeedback entails using feedback from electronic devices to control body functions to promote muscle relaxation and decreased muscle tension.
  3. Deep breathing means concentrating on taking slow, deep, even breaths.
  4. Guided imagery involves concentration on pleasing images to take the place of negative or stressful emotions.
  5. Progressive relaxation entails tightening and relaxing various muscle groups, and is often combined with deep breathing and guided imagery.
  6. Self-hypnosis facilitates the relaxation response by means of a verbal or nonverbal cue (ie, suggestion).

Meditation and yoga can also be considered relaxation techniques.

Physicians can learn more about relaxation techniques from a variety of other health professionals, including other physicians, psychologists, social workers, nurses, and complementary health practitioners. Alternatively, these techniques can be learned through self-directed instruction.

Effects on health

A lot of the research examining the potential health benefits of relaxation techniques has been low-powered and of poor quality. Nevertheless, researchers have looked at the effects of relaxation techniques in a wide range of diseases, such as anxiety, depression, headaches, musculoskeletal pain, and heart disease—most of which are experienced by physicians with high-stress jobs.

Research shows that relaxation techniques can help relieve anxiety from heart disease and inflammatory bowel disease, as well as in people undergoing certain medical procedures. Of course, relaxation techniques are adjunctive for most conditions, such as generalized anxiety disorder in which the standard treatment is cognitive-behavioral therapy (CBT).

Limited research shows that relaxation techniques also help with depression and, as with generalized anxiety disorder, CBT likely works best.

A 2013 study showed that electomyographic (EMG) biofeedback could help decrease the pain of fibromyalgia for short durations of time. However, this approach did not help with related sleep problems, depression, fatigue, and quality of life. Findings regarding the use of guided imagery to treat fibromyalgia symptoms are mixed.

Some research has also shown that biofeedback is associated with decreased incidence of migraines, but it was unclear whether biofeedback outperforms placebo. On a related note, findings of the effects of relaxation techniques on tension headaches are mixed.

Biofeedback may also help with cardiovascular conditions.

“In people with heart disease, studies have shown relaxation techniques can reduce stress and anxiety and may also have beneficial effects on physical measures such as heart rate,” according to the NCCIH website. “Stress can lead to a short-term increase in blood pressure, and the relaxation response has been shown to reduce blood pressure on a short-term basis, allowing people to reduce their need for blood pressure medication. However, it’s uncertain whether relaxation techniques can have long-term effects on high blood pressure.”

Emerging research findings have indicated that guided imagery may help treat pain. In inpatient cancer patients, for instance, guided imagery and relaxation response training decreased pain and anxiety.

Finally, most physicians should be able to safely engage in relaxation techniques without fear of negative side effects. Some people, however, have reported heightened anxiety, intrusive thoughts, or fear of losing control after engaging in relaxation techniques.

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