WELLNESS: A MODEL OF HOLISTIC HEALTH

Physical Activity and Fitness

We all know being physical active (or at least not sedentary ) is important for our physical wellness. There is an increasing body of literature differentiating the importance of body composition from body weight. Increased lean muscle mass and reduced abdominal fat are measures of fitness, independent of total body weight14=16. From a wellness perspective, “fitness over fatness” resonates intuitively with many people because the total health of the individual is prioritized over individual measures. Offering an example of the connection between the difference facets of wellness, is the fact that physical activity also improves mood17-19. Positive changes occur in the brain when we exercise, including increases in the neurotransmitter serotonin (the pharmacologic target of numerous antidepressant medications) and in the number of dopamine receptors in the brain. Because dopamine is generated in times of pleasure and reward, physical activity does become a self-reinforcing habit once you get started!20 Even more fascinating, exercise may induce the generation of new connections (or synapses) in a region of the brain called the hippocampus. This process is called “neurogenesis” or the generation of new nerve pathways. Interestingly, neurogenesis is known to be suppressed in association with both depression and obesity, which helps to explain why it can be difficult to learn new things, or motivate to engage and create when people are depressed.21
 

Emotional Wellness

Although inseparable, beyond physical wellness comes emotional wellness. Interestingly, in most of medicine, emotional wellness is equated to “mental health”. This mislabeling is typical of biomedicine. In the absence of an identifiable “emotional organ,” the brain, with its pathways and transmitters became the epicenter of biomedicine’s quest to affect emotions using medications. From this mechanistic construct, came the search for drugs to replace depression, grief and anxiety with blunted emotions by binding some receptors and blocking others. Needless to say, turning down the temperature on the oven when the timer goes off will only delay, not prevent, the dish from burning! This reductionist thinking has also influenced the delivery of “mental health” services around the world, and has resulted in a crisis in many US healthcare facilities. Sadly, the consideration of other approaches to emotional health, i.e., mindfulness training, physical activity, cognitive behavioral therapy, etc., rarely enter the conversation in mental health facilities burdened by more patients than time. Admittedly, acknowledging, processing, accepting and moving beyond one’s emotional states requires a lot more work, time and emotional energy!

Interestingly, the ancient texts of the discipline of Ayurvedic medicine identified an emotional center in the human body thousands of years ago, i.e. the heart chakra .22 Although biomedicine doesn’t locate the emotional center in the anatomical heart, we have all felt this truth as heart palpitations from anxiety, a “broken heart” from lost love or a “heart ache” from grief. Fortunately, some leaders in biomedicine have made advances in explaining the heart as our emotional epicenter. Some of the best examples of this research, and its practical application to improving emotional wellness, have been done by the HeartMath Institute in Boulder Creek, California, USA. HeartMath™ is a therapeutic approach that uses biofeedback to reprogram reactions to stressors (not unlike mindfulness meditation). HeartMath™ focuses attention on the heart, uses heart-centered breathing (described as extending the exhalation longer than the inhalation) and many other mind-body exercises which can be learned at home, and then practiced as needed, any place at any time.23 Their research suggests that people who practice HeartMath™ principles experience lower blood pressure and people with diabetes experience increased well-being from following the practices.24

Science aside, how do we know when we’ve achieved emotional wellness? I like to think you know you have achieved emotional wellness when you are not limited by stress, anxiety or fear to give and receive love. Although upon first read, many may consider “love” to be related to romantic love, but romantic love isn’t necessary for emotional wellness. Giving love may be as simple as extending a helping hand to someone in need, or smiling at a child. Similarly, receiving love may be as simple as allowing someone to help you, or accepting a compliment with grace. Not receiving very much love? Try giving some out. Love is an unlimited force and giving some away doesn't create a void, rather it helps create the space to accept love in return.

Intellectual and Cognitive Wellness

Intellectual stress is a relatively modern phenomenon- historically the most difficult intellectual tasks consisted of where to find food and when to seek shelter from the weather- and family, community and social structures helped protect individuals and their clans to ensure survival. But today, we often feel we are on our own to survive and intellectual stressors bombard our day-to-day lives. Balancing checkbooks, learning new technologies, using “apps”, remembering passwords (each requiring its own combination of letters, numbers, symbols and security questions) all present new challenges and stressors. All of these tools, designed to make tasks “easier” have accumulated to become stressors in our day-to-day “life” The result is a major increase in cumulative screen time and less time being present with friends and family. The psychology literature now describes several distinct phenomena and psychological dysfunctions related to technology, and its over use25. Over use of technology and its collateral psychological effects can include:

• Reduced attention span: continuous partial attention and attention-deficit trait

• Inhibited creative thinking and cognition: digital fog and techno-brain burnout

• Overloaded unfocused activities: data smog and “frazzing” (frantic ineffectual multitasking)

• Addiction: on-line compulsive disorder

• Agoraphobia: fear of leaving the house and interacting with the outside world

Soon we will not even have to use a separate device to interact with technology, rather it will be inherent in our living environments, like our cars and homes, and in our accessories like glasses and clothing. So how do we balance the benefits of technology with its darker sides of brain-numbing distraction and impersonal relationships? A good start is to create time away from screens and devices with personal discipline around when to be “screened-in” and when to take “data fasts”. Dedicating time throughout the day to turn devices off or leave them at home or in the office not only creates more time to spend with real people (giving and receiving love) but also frees up mental space for self-reflection, personal creativity, quiet mental calm, and even thinking for yourself!

Spiritual Wellness

Many equate spirituality with religion, and many people do find spirituality through their religious practices. However, generically, spiritual wellness is the quest for meaning and purpose in our lives through connection with something larger than our self. The goal of most spiritual practices is to find harmony and peace within one’s self and within our relationships with other entities, including humanity and our physical environment. Spirituality also guides how we approach our daily activities, i.e., ideally with compassion, self-giving, mindfulness, gratitude and love. Spiritual wellness is a highly individualized pursuit and each person must explore their own sense of meaning and purpose, in order to find practices that foster spirituality within their own lives. Yet, most spiritual practices share common tenants, including mindfulness, inter-dependency on one another, and non-violence.

The importance of spirituality has also undergone scientific inquiry. The University of Minnesota Center for Spirituality has probably done more than any modern U.S. university to help generate a literature base for the study of spirituality and the effects it has on personal health. Among their research findings, people who engage in daily spiritual activities experience more meaning in life, higher self-esteem, and a more positive overall mood.26 The “interventions” that get us here range from 8-week spiritual awareness programs,27 to spending more time in nature28, to attending church potlucks with your community.

Social Wellness

Abraham Maslow, an early 20th century psychologist, is credited with first articulating the importance of the social setting in which we live as critical to the health of the individual. Maslow’s hierarchy of needs (Figure 2), first proposed in 1943, suggests human potential is realized systematically, by ascending different stages of personal and social security, eventually allowing individuals to “self-actualize” or create their lives with creativity and autonomy29. It isn’t surprising that humans are selfishly motivated to first meet their basic survival needs, i.e., food, water, shelter and security. Other values become lower priorities until these needs are met. Thus “higher” levels of development, i.e., creativity and self-actualization, are unattainable until basic needs are met . However, social wellness extends beyond our physical needs on the pyramid, and therefore is critical to “climbing” up the ladder.

Do you feel safe, secure and supported in your social sphere? There are numerous ways to give your social wellness some much needed attention, including making more time to spend enjoying activities with friends and family, but also reaching out to your neighbors and community to tell them they are not alone and to help assure their safety (which in turns does the same for you!). Although our virtual social networks provide us with the façade of social health and connection, they don’t help in a snowstorm, an emergency situation, or when you need someone’s physical shoulder to cry on. Some practical ways to help encourage social wellness are to make an effort to meet your neighbors, organize a block party or community event, participate with a local community center, create a block watch or contact list, and make a little extra time for family, church and other gatherings. Try to influence multiple facets of wellness simultaneously by stimulating healthful exchanges like walking clubs, community potluck meals, or shared spiritual practices like group meditation or prayer.