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Mindfulness: Helping The Body Heal From Chronic Stress

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For thousands of years, various cultures have utilized the practice of mindfulness as a way to cultivate well-being, and over the last several years, scientific advances have helped to confirm its benefits. While scientific understanding of meditation is still in its infancy, research suggests that mindfulness practice is a powerful modulator of structural and functional brain plasticity.1-4
Two common types of meditation include focused attention (FA), such as Himalayan yoga, mantra, and metta, and open-monitoring (OM) meditation, like zen, Isha yoga, shoonya yoga, and vipassana. Both types have been shown to enhance attention control, emotion regulation, and self-awareness, as well as improve cognitive control of conflict.2 There is some evidence that FA, OM, and transcendental meditation (TM) may result in both long-term and short-term changes in the brain, including increases in the cortical thickness of regions like the prefrontal cortex and insula. All forms of meditation result in significant changes in cortical and subcortical activity; however, different forms elicit activation in different regions of the brain.2
A 2022 review suggests that different styles of meditation can alter the functional activity and connectivity of the prefrontal cortex (PFC) region, which is associated with increased attentional function, working memory, cognitive control, executive control, emotion regulation, countering negative effects, self-awareness, and compassion.5 The overall increase in functional connectivity and activity of the PFC may explain the decrease in anxiety, depression, perceived stress, negative emotions, and hyperarousal symptoms in meditators. 5
Physiological Effects of Meditation
Beyond the brain, meditation has been found to influence physiological measures like heart rate, respiratory rate, systolic blood pressure, and diastolic blood pressure.6 In a recent study, the effect of short- and long-term Brahma Kumaris Raja yoga meditation was shown to improve basic cardiorespiratory functions. Raja yoga shifted the autonomic balance in favor of the parasympathetic system in those who practiced it long-term (more than five years).6
Three years later, Raja yoga was studied again, and it was suggested that in long-term meditators, the shifting of the autonomic balance to the parasympathetic side may combat the ill effects of stress.7 This benefit is not only for patients, as several studies have looked at the effectiveness of mindfulness-based interventions for clinicians.8,9and have identified a range of beneficial physiological and psychological outcomes.10 For healthcare professionals, some researchers have suggested that mindfulness meditation reduces stress, anxiety, and burnout and enhances resilience.10-13
Mindfulness and Stress
Poor stress-coping contributes to the development of chronic diseases, and a 2003 study in blood cells found that the mindfulness-based stress reduction (MBSR) program reduced cytokine secretion, oxidative stress, and DNA damage.13 Researchers in a 2014 study on gene expression found that after a meditative intervention, there was a decreased expression of pro-inflammatory genes (RIPK2 and COX2) in meditators compared with controls.14
Chronic work-related stress is a significant risk factor for cardiovascular and metabolic diseases and mortality.16 Meta-analysis concluded that work stress can increase the risk of myocardial infarction by 50%.16 Management of stress and the sympathetic response not only affects hormonal systems but significantly affects neurological, biochemical, and other influences that play a role in pain and systemic metabolic functioning.18 A study examining the effects of a meditative tai chi program in chronic heart failure participants showed that regular practice had a beneficial effect not only on health-related quality of life and resilience but also on body mass index and blood pressure levels.18
Other studies have also suggested that yoga can affect cardiac autonomic regulation.19 Although the mechanism by which yoga influences autonomic activity is not well understood, a 2016 study found that some yoga practices appear to directly stimulate the vagus nerve and enhance parasympathetic output, leading to parasympathetic dominance and enhanced cardiac function, mood, and energy states, as well as enhanced neuroendocrine, metabolic, cognitive, and immune responses.19
In 2019, a pilot randomized controlled trial with 34 young adults provided tentative evidence that TM may impact biological stress system functioning.15 Study participants were randomly assigned to TM training followed by eight weeks of meditation practice or a wait-list control condition. Individuals in the TM group had lower awakening salivary cortisol levels and a greater drop in cortisol awakening response from baseline to week four than the control group.15
A 2023 systematic review and meta-analysis of 11 articles suggests that, among Chinese college students age 18-22, mindfulness-based interventions ranging from 10 days to 8 weeks significantly decreased anxiety scale scores.20 Four types of mindfulness were used in the studies: MBSR, mindfulness-based cognitive therapy (MBCT), MBSR combined with MBCT, and mindfulness with meditation therapy in general.20
Functional Medicine Considerations
With a wide range of stress-related chronic diseases on the rise, how can functional medicine clinicians target stress-related factors with interventions that improve the health of their patients? Many diseases stemming from chronic stress have early warning signs, meaning some cases may be prevented or improved with lifestyle changes that help manage stress. The functional medicine model focuses in on identifying stress as a cause of dysfunction and utilizing specific interventions like exercise, meditation, and yoga that work for the individual patient. Tools such as the functional medicine timeline can also help clinicians identify areas of life where stress may be problematic and design treatments that focus on improving stress management.
Mental, emotional, and spiritual balance are at the center of the functional medicine matrix, in recognition of their influence on all the other biological systems. Mindfulness practices have the potential to greatly influence this balance, which is why they have been used for thousands of years in various cultures to promote healing and wellness. What other lifestyle modifications can help patients who struggle with stress and inflammation? Learn more in IFM’s foundational course, Applying Functional Medicine in Clinical Practice (AFMCP).
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References
- Tang YY, Posner MI. Tools of the trade: theory and method in mindfulness neuroscience. Soc Cogn Affect Neurosci. 2013;8(1):118-120. doi:1093/scan/nss112
- Lee DJ, Kulubya E, Goldin P, Goodarzi A, Girgis F. Review of the neural oscillations underlying meditation. Front Neurosci. 2018;12:178. doi:3389/fnins.2018.00178
- Tang YY, Hölzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci. 2015;16(4):213-225. doi:1038/nrn3916
- Behan C. The benefits of meditation and mindfulness practices during times of crisis such as COVID-19. Ir J Psychol Med. 2020;37(4):256-258. doi:1017/ipm.2020.38
- Rathore M, Verma M, Nirwan M, Trivedi S, Pai V. Functional connectivity of prefrontal cortex in various meditation techniques – a mini-review. Int J Yoga. 2022;15(3):187-194. doi 4103/ijoy.ijoy_88_22
- Sukhsohale ND, Phatak MS. Effect of short-term and long-term Brahmakumaris Raja yoga meditation on physiological variables. Indian J Physiol Pharmacol. 2012;56(4):388-392.
- Bharshankar JR, Mandape AD, Phatak MS, Bharshankar RN. Autonomic functions in Raja-yoga meditators. Indian J Physiol Pharmacol. 2015;59(4):396-401.
- Ribeiro Santiago PH, Colussi CF. Feasibility evaluation of a mindfulness-based intervention for primary care professionals: proposal of an evaluative model. Complement Ther Clin Pract. 2018;31:57-63. doi:1016/j.ctcp.2018.01.013
- van der Riet P, Levett-Jones T, Aquino-Russell C. The effectiveness of mindfulness meditation for nurses and nursing students: an integrated literature review. Nurse Educ Today. 2018;65:201-211. doi:1016/j.nedt.2018.03.018
- Townsley AP, Li-Wang J, Katta R. Healthcare workers’ well-being: a systematic review of positive psychology interventions. Cureus. 2023;15(1):e34102. doi 7759/cureus.34102
- Alhawatmeh HN, Rababa M, Alfaqih M, Albataineh R, Hweidi I, Abu Awwad A. The benefits of mindfulness meditation on trait mindfulness, perceived stress, cortisol, and C-reactive protein in nursing students: a randomized controlled trial. Adv Med Educ Pract. 2022;13:47-58. doi:2147/AMEP.S348062
- Lee M, Cha C. Interventions to reduce burnout among clinical nurses: systematic review and meta-analysis. Sci Rep. 2023;13(1):10971. doi 1038/s41598-023-38169-8
- Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65(4):571-581. doi:1097/01.psy.0000074003.35911.41
- Kaliman P, Alvarez-López, MJ, Cosín-Tomás M, Rosenkranz M, Lutz A, Davidson RJ. Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators. Psychoneuroendocrinology. 2014;40:96-107. doi:1016/j.psyneuen.2013.11.004
- Klimes-Dougan B, Chong LS, Samikoglu A, et al. Transcendental meditation and hypothalamic-pituitary-adrenal axis functioning: a pilot, randomized controlled trial with young adults. Stress. 2020;23(1):105-115. doi:1080/10253890.2019.1656714
- Cheema BS, Marshall PW, Chang D, Colagiuri B, Machliss B. Effect of an office worksite-based yoga program on heart rate variability: a randomized controlled trial. BMC Public Health. 2011;11:578. doi:1186/1471-2458-11-578
- Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A, Vahtera J. Work stress in the etiology of coronary heart disease—a meta-analysis. Scand J Work Environ Health. 2006;32(6):431-442. doi:5271/sjweh.1049
- Sun J, Buys N, Jayasinghe R. Effects of community-based meditative tai chi programme on improving quality of life, physical and mental health in chronic heart-failure participants. Aging Ment Health. 2014;18(3):289-295. doi:1080/13607863.2013.875120
- Tyagi A, Cohen M. Yoga and heart rate variability: a comprehensive review of the literature. Int J Yoga. 2016;9(2):97-113. doi:4103/0973-6131.183712
- Li J, Xu C, Wan K, Liu Y, Liu L. Mindfulness-based interventions to reduce anxiety among Chinese college students: A systematic review and meta-analysis. Front Psychol. 2023;13:1031398. doi 3389%2Ffpsyg.2022.1031398