The Lifestyle Medicine Approach to Emotional Well-Being

We live in a stressful world, and the COVID-19 pandemic made that even worse. We are bombarded daily with news coming at us from multiple sources—good, bad and often conflicting—and refining new ways to work and engage with family members. Some of us are comfortable reconnecting with others in person while others are choosing to remain isolated due to personal fears or health needs.

Managing stress effectively and fostering social connections are vital components of emotional and social health. For that reason, they are two of the six pillars of lifestyle medicine. In a world where we frequently hear about politics, violence and climate change, it can be challenging to reduce your stress. It can also be difficult to build new social networks as an adult, regardless of the pandemic.  Here Heidi Prather, DO, who leads the HSS Lifestyle Medicine Program, shares information about the effects of stress and isolation on your health and well-being and the benefits of reducing your stress and forging new social connections. 

How do stress and isolation affect our health?

Not all stress is bad. An approaching deadline can motivate you to finish a project or accomplish a challenging goal. But negative stress, especially if it is chronic, can cause anxiety and impair your performance, leading to poor mental and physical health. Chronic stress has been shown to raise levels of inflammatory markers in your body, impeding your ability to lose weight and making chronic pain feel worse. If you have a chronic disease or disorder such as arthritis, uncontrolled stress can actually worsen your symptoms and cause more physical discomfort.

Research shows that the single most important predictor of human happiness and a longer life is having strong social connections. Even short-term positive social interactions can improve blood pressure and heart rate. Studies have shown that happy people are more likely to be resilient, cooperative and forgiving and have more robust immune systems and better pain tolerance. Happiness and well-being are nurtured by activities that foster positive emotions, engagement and meaning.

A lack of social connectedness may cause depression and/or anxiety and also has negative effects on the physical body. Studies have shown that if you separate mice in a lab, with one mouse alone and others living together in a cage, the mouse that lives alone is less active, gains belly fat and develops insulin resistance.

What are some ways to better manage the stress in my life?

Some stress is unavoidable, but there are things you can do to achieve calmness and to relax, such as box breathing—a very centering exercise. Inhale for four counts, hold your breath for four counts, exhale for four counts, and wait another four counts before inhaling your next breath. With each breath, visualize drawing a line of a box that connects to the lines drawn during the other breaths. 

Sometimes there is only so much box breathing you can do. That's where counseling—such as cognitive behavioral therapy (CBT)—can be helpful. You can schedule one-on-one visits with a therapist or health coach. If time, insurance or finances limit your ability to see a therapist, consider a mental health app. Some of these app services use artificial intelligence to provide support while others enable you to connect with a therapist virtually. Speak with a lifestyle medicine physician or your primary care provider about the most effective approach for you.

Here are some other stress management tips from the American College of Lifestyle Medicine (ACLM):

• Try different healthy ways to relax (music, exercise, dance, meditation or yoga). There are many apps that provide these services.
• Take time for yourself to enjoy fun creative activities or hobbies.
• Keep a gratitude journal or write about stressful events.
• Take care of your spiritual needs.
• Make time to laugh by watching a comedy or funny video, meeting with a humorous friend or just laughing out loud.
• Avoid caffeine and alcohol, which can exacerbate stress.
• Get a massage.
• Call a supportive friend or family member.
• Participate in activities with others.

How can I improve my social connectedness?

Social connectedness is like a muscle that needs to be exercised. Moreover, social connections need to be positive and reinforce healthy lifestyle choices. If you're trying to be more active, reach out to a friend, relative or coworker to hike, go for a walk or take a yoga or art class together. Connect with other people to make a healthy dinner together. 

It can be intimidating to try to make new friends as an adult, but with virtual connections, it's become easier. Check out Meetup to find a group near you and meet new friends who enjoy similar interests. There is a group for practically every interest and activity. Some are virtual and many meet in person. 

To form new social connections and bolster a greater sense of purpose and belonging, the ACLM recommends:

• Volunteering for an organization whose goals you support
• Connecting with a community resource center 
• Joining a religious or spiritual group
• Attending a music performance, lecture, art exhibit or local sports event
• Organizing community events by joining a committee or board
• Attending community celebrations like parades or walks
• Taking a course at your local library or community college

How does an HSS lifestyle medicine provider help set goals to manage stress and promote social connections?

The HSS lifestyle medicine provider will perform a comprehensive evaluation, which includes asking you questions about depression and anxiety and whom you identify as sources of positive social support. You may participate in group meetings with others in the program, which foster community and mutual support. Your provider will work with you to set goals that are:

• Specific: What are you going to do to reduce your stress and improve feelings of connectedness?
• Measurable: How much time will you devote to these activities?
• Attainable: Do you have what it takes to follow through?
• Realistic: What can you actually do? Focus on improvement over perfection.
• Time-connected: How frequently will you work on your goals? How long will you commit to the process?