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Interviewer: We thought we take a moment here on The Scope Health Sciences Radio to do a mindfulness exercise. We're with Dr. Paul Thielking. He's at Huntsman Cancer Institute's Wellness Survivorship Center. He teaches an eight week mind and body skills group for cancer patients and a lot of it is being mindful to reduce stress and to sometimes reduce pain and I thought we'd do a quick exercise to see how this works. So, teach me this simple exercise. What's this one called?

Dr. Thielking: So, we'll just call this a breath meditation. Focusing on the breath as a very basic kind of starting point for a lot of mindfulness practices.

Interviewer: Okay. And what benefit should I experience when we're done doing this?

Dr. Thielking: Well, I'm hoping that by the time we're done with this very short exercise, you might feel a little more relaxed, like we do right now. Unless you're super relaxed already.

Interviewer: All right.

Dr. Thielking: And maybe you'll just feel a little more present with whatever is happening in the moment.

Interviewer: All right. I'm going to see if that happens. I'm curious about this.

Dr. Thielking: Sometimes it's better to actually do this as an experiential exercise than for me to talk about it.

Interviewer: Okay.

Dr. Thielking: So this is a great way to start.

Interviewer: Okay. So I invite our listeners right now, it's just going to take a couple of minutes.

Dr. Thielking: Let's say two to three minutes.

Interviewer: Okay. So we're just going to take a couple of minutes. So push your keyboard and mouse away and do this with us.

Dr. Thielking: And I'm rushing through this a little bit. So just to start with, make sure you're in a comfortable position. To start with, just focus on your body. Just notice if there's any areas that feel tense, if you're carrying any stress or tension in your body, your back, or your shoulders, any place else. And just quickly check in emotionally with how you're feeling right now. And then just notice what's going on with your thoughts, whether your mind is active or quiet. A

And anything is okay, whatever is going on right here right now in your experience is fine. We're not trying to change or manipulate it. It's just kind of taking an inventory. And then just notice your breath and for the next few breath cycles just focus on breathing in a little more deeply and a little more fully with each in breath. And then having a relaxed, slow exhalation. We do that two more times deepening and slowing your breath.

And then after your next exhalation, I'd like you to keep your mind focused on your breath but simply following it. You're not trying to change it. You're simply following your natural breathing, your in breath and your out breath. And if you find your mind getting distracted or yourself thinking about other things, you just gently bring your focus back to your breath. And sometimes it can actually help to count your breaths like counting up to four and then starting over again.

So in a real mindfulness kind of session, we might go on like this for another 10 or 15 minutes where we're just keeping our focus on our breath and bringing our mind back to our breath whenever we find ourselves distracted in a very open non-judgmental sort of way. Usually when people start with something like this, they might find their mind wandering before they can get to the second breath, that's normal. With practice though, it actually gets easier and we might even realize how often we're caught up in our minds, we're worrying about things when we weren't aware of it before. So this is a very short introduction in the interest of time but this is a basic mindfulness exercise that again, you might sit down and do for like 10 minutes as a starting point.

Interviewer: You were so right. I found my mind thinking about all the million different things that it's always thinking about. And then eventually there was a brief, brief little moment where it was completely blank and free. And you know how cool that felt? It felt really cool.

Dr. Thielking: If you allow your mind to relax like that, your body kind of follows and is able to relax too. That's the intention of this kind of exercise for people that are going through stress.

Interviewer: So I find myself kind of smiling too. Is that a normal response?

Dr. Thielking: Yeah. I think the things that people find as they feel more relaxed physically. Emotionally they might just feel a little more light, a little more at ease with whatever is going on. The mind naturally tends to settle after a little while. Maybe a minute or two is not quite long enough to notice some of these effects but the basic exercise of just coming back to the breath, people can just do on their own for as long as they want.

Interviewer: How about before you go to bed at night? Maybe schedule an extra 15 minute and just lay there and do this exercise?

Dr. Thielking: Yeah. It's great. Like you're pointing out you've got a million other things going on in your mind right now because you're in the middle of a busy day. The morning, first thing in the morning after getting out of bed or the evening before going to bed tend to be the easiest times for people to find a quiet place to set aside and do this sort of exercise. Some people are morning people, some people are evening people.

What I would suggest if you're interested in trying this is that you try to set aside 10 or 15 minutes everyday at the same time each day. It could be in the morning, it could be in the evening, it could be in the middle of the day if that works for you. And that you just try it for a week or two and you just have an open mind and notice whether it makes a difference or not.

Interviewer: Yeah. Having the open mind is kind of hard I think because if somebody was to come by as I'm sitting here breathing deeply, I'd feel a little silly about that maybe.

Dr. Thielking: Yeah. You might feel that way because you're doing it in kind of a public place right now.

Interviewer: Yeah, sure. Fair enough.

Dr. Thielking: But if you can find a quiet place alone in your own home, then you don't have to worry about what other people think.

Interviewer: Yeah.

Dr. Thielking: I mean sometimes I've done this, like sitting on a bus, sitting there with my eyes closed on a bus. You can find places like out in public too where it's not that noticeable. You're not calling attention to yourself.

Interviewer: So try it for a couple of weeks, keep an open mind. I can tell you I already feel a little bit more relaxed. I mean I think of all the stimulus we get on a daily basis. I've got my email open, I've got my phone, I've got messages coming through there. I'm thinking about my next thing and that little two minute period actually was kind of nice and I do feel a little refreshed.

Dr. Thielking: Yeah. It's kind of stepping away from all the stress in our lives even if it's just for 5 or 10 minutes. And if you do that on a regular basis you can actually make a difference and you can get back in your life with a clear, refreshed state of mind.

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updated: July 16, 2019
originally published: April 29, 2015

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Dr. Jones: It is okay to drink to relieve stress? I would say, probably not on a regular basis. Now, I have often had days, personally, when my day was just awful, and it was stressful, and I am thinking in the clinic, "Oh I just want to go home and have a drink." In fact, those are specifically the days I don't drink. Those are the days when I need to be on top of my game to handle what's going on at home. So, if I'm already stressed, and I'm going home to a social situation, I want to be on the top of my game. I don't want to be affected by alcohol in my relationships with my husband, or my kids, or my friends, so I specifically would say learn other techniques to help deal with your stress.

When you get home, instead of opening that bottle, do you have time to go for a little walk? Exercise is a great stress reliever, and you don't have to run and get sweaty. Just go outside, look at your neighbor's garden, just walk up and down your neighborhood for half an hour if you've got the time. Maybe only 20 minutes. Take a deep breath. When you get home, sit down, and if you've got lots of kids, go in the bathroom and shut the door. Sit in the bathtub for a little bit. Sit on the potty if you don't have time for a bath, or you don't have a bathtub. But you know, it turns out for most families the bathroom is private time, so go in there, shut the door, and take a deep breath.

Count your blessings. You're home now. And take a deep breath because you do want to be at the top of your game when you get home after a busy day. If home is the source of your stress, therefore, and you can't get away because you're at home full time, that's where you need your girlfriends, you need your walking, you need your bathtub, or you need your clinician to help you deal with the stress at home. So, I would say the people who probably shouldn't drink are the people who are stressed.

Having said all that, this is probably more than you wanted to hear, if the stress reliever is a social situation; so, you had a stressful day and you and your buddies go out for a drink and it's really the social situation which is decreasing the stress. You're with someone who you can gripe with and you can laugh with. Having a drink in that social situation, as long as you're not driving home, is probably a fine thing because the stress reliever is the social situation. But if you're going home alone, going home to children, or you're at home alone or with family, and you're drinking to relieve stress, not in a social situation, I'd say it's a bad idea.

It is definitely a habit that women have to use alcohol to relieve stress. It's pretty effective actually. Alcohol is a downer, so alcohol is a sedative. So if you're all wound up, and your hearts beating, and you're stressed out, alcohol can definitely make those symptoms of stress go down. The problem is alcohol interferes with your ability to make good decisions, and that's a problem, particularly if you're stressed. Number two, alcohol interferes with your sleep. It may make you sleepy originally, but it inhibits REM sleep, so often people wake up at 3:00 or 2:00 at night, and they can't get back to sleep, or often they wake up with their heart pounding.

So, it's a little counter intuitive to say, yes, temporarily it relieves stress, but you don't always think as clearly after you've been drinking, and you don't sleep as well. And both of those are going to impact how well you deal with stress tomorrow. So, it can be a habit. It's a habit worth breaking. And it's habit worth substituting with more both social acceptable and personally healthy ways of dealing with stress.

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Interviewer: If you've ever had the thought that eating healthy stresses you out there could be hope. We're going to talk about that next on The Scope.

Man: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Trying to eat healthy stresses me out. If this resonates with you, you're going to want to find out what Staci McIntosh, Registered Dietitian and Assistant Professor at the Department of Nutrition at the University of Utah, has to say.
I've experienced this personally where I've tried to eat what I consider healthier - fruits, vegetables, closer to the source type foods, combining protein and carbs in the right ratio, the correct quantity of food to eat. It takes forever to prepare food this way, it takes forever to eat food, and it stresses me out. Do you ever run into this?

Staci McIntosh: I do, I do. I think we all do.

Interviewer: Help!

Staci McIntosh: One of the things that I tell my patients is let's look at it this way. Whatever you normally ate, whatever you ate before you came into see me today, I'm not taking that off the plate, but I want half the plate to be a salad or other green vegetables.

Interviewer: Okay.

Staci McIntosh: Then, the other half you can eat what you normally eat. We'll work on that later. Right now all we want to do is try to get half of your plate to be leafy green vegetables.

Interviewer: Okay. You get half the plate to be leafy green vegetables, but eventually we're going to get to this place that I feel that I'm at where it takes forever to eat. Because in order to get the calories I need I'm eating a cup of broccoli, and a big salad, and a couple of pieces of fruit, and you've got to do that four or five times a day.

Staci McIntosh: Yeah, you do.

Interviewer: That's just the way.

Staci McIntosh: There are no shortcuts, and there have never been any shortcuts. There never will be any shortcuts. If you want to eat healthy and be healthy then you've got to do the work. No one expects to have big biceps if I don't do curls or whatever. If I don't do arm exercises, I don't expect to have big biceps. Why would I expect to be healthy if I don't eat healthy?

Interviewer: Yeah. Is it okay to get some of my calories from a few chips along with my freshly made salsa along with my chicken breast?

Staci McIntosh: Absolutely.

Interviewer: That's fine, even though it's a processed food. That stresses me out, too. I'm trying to eat the fewest processed foods I can.

Staci McIntosh: Eating is a basic enjoyment of life. The minute it becomes an obsession and it's stressing you out it can no longer be a basic enjoyment of life.
Eating healthy and taking pride in that, and knowing that you had your salad, you got that in first, you're going to take 30 minutes to eat this meal, you're not going to swallow it whole in five minutes flat, then you know that you got in the good stuff. You're giving your body time to digest that and the hormones to get to your brain to tell you whether or not you're full.
Then, yeah, I'm still going to eat my lasagna that's full of cheese or whatever else that is on your plate for that night, but there's no reason to feel guilty about that. You still need the nutrients.

Interviewer: What about fat? I feel guilty about eating fat as well, like nuts and seeds, but yet some people say that's what I should be incorporating.

Staci McIntosh: There are essential fatty acids that you have to get from your meal, and you don't get them from anywhere else unless you're relying on supplements for your life. You do need fat, and fat is a good stimulator of satiety. It triggers a couple of different hormones during the digestive process that tells your brain you're full. If you're eating a diet that's fat free, you're not getting in those hormones, you're not getting that early satiety, and you're getting hungry much quicker in between meals.

Interviewer: At the end of the day how do I know if I'm eating healthy enough? Is it a weight monitoring thing? If I start gaining weight then I go well maybe I should cut back a little bit? How do you make that judgment without getting out the food journal and writing all that down?

Staci McIntosh: How do you feel about it? Nutrition is not rocket science. You know if you ate well today. You know if you ate good, and if you were hungry all day, or if you're obsessing over your food all day, or if you feel really bad because you ate half of a birthday cake for lunch. You know that. You know if you ate well or not.

Interviewer: What's my takeaway here? How do I start to a less stressful eating lifestyle?

Staci McIntosh: Focus on whether or not you're getting in your fruits and vegetables. Don't worry so much about the other stuff that you're getting in, if you're getting in your meat, or chicken, or meat substitute, or carbohydrates. If I get in all of my fruits and vegetables for the day I'm feeling pretty good and I need other calories to support my lifestyle.
At the end of the day if I realized, you know, I think I only had one serving of vegetables today, well I'm not going to have ice cream before I go to bed. I'm going to have an apple or an orange. I'm going to have some other source of antioxidants and good vitamins and minerals.

Man: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: What is too much stress? Is worrying too much a problem? Can you un-worry? Is there a difference between good stress and bad stress? We'll talk about that next on The Scope.

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Interviewer: We're talking with Psychiatrist Dr. Jason Hunziker from the University of Utah. Dr. Hunziker, first of all explain to me what is good stress. Is there a good stress?

Dr. Jason Hunziker: I guess there's good stress. I mean there are definitely events that are positive in our lives that clearly cause stress. But I also think that there are stressors that can be considered motivating to help us accomplish our goals.

Interviewer: Some examples of that?

Dr. Jason Hunziker: So let's say you have a large test coming up on Friday. That stress makes it so you want to study so you can prepare for that test that you need to take care of.

Interviewer: Okay.

Dr. Jason Hunziker: Now I would consider that good stress; other people would say, "Oh, that's terrible stress. I can't handle that." But I think we're all different that way.

Interviewer: So what is the definition for you of a good stress?

Dr. Jason Hunziker: I think good stress for me is something that encourages me to better myself and to motivate me to want to get up and do something rather than cause me to be paralyzed and not be able to function.

Interviewer: So I'm assuming there are benefits to good stress then, right? It's motivating?

Dr. Jason Hunziker: Definitely, I think there are always benefits to good stress. And for me stress can be motivating and make me want to be better and maybe want to improve what I'm doing. But then there are times where even just adding a little bit more stress can destroy the whole thing.

Interviewer: So there's a very good chance that the good stress can become bad stress?

Dr. Jason Hunziker: Definitely.

Interviewer: And what is bad stress?

Dr. Jason Hunziker: Well I think bad stress is anything that will impact or interfere with your life. If it doesn't allow you the opportunity to continue to improve and accomplish the goals that you have, then that stress becomes debilitating and then that leads to more complications.

Interviewer: So obviously there are two ways that you can have bad stress. One is that maybe you have too much of good stress, but generally if you're not having those kinds of stresses where does bad stress come from?

Dr. Jason Hunziker: Well I think bad stress is something that again is a definition that might be different for me than for others. But it can come even from normal daily activities that just seem to be too overwhelming. And I can give an example of that. Let's say that you're going to get married, which would be a positive event in your life, but you're also trying to go to school. You're also trying to work every day. Then you get a traffic ticket and then your significant other has a problem and falls down and breaks his leg. All of a sudden this good stress that you had that was so exciting, that was motivating you to get prepared for, you start adding all of these things up and the stress load is just too high for you to function.

Interviewer: Is there any physical health conditions that bad can come from too much stress or too much bad stress, or good stress?

Dr. Jason Hunziker: Well unfortunately stress often leads us to do things to try to alleviate the stress in a rapid fashion. Sometimes we choose to do things that aren't quite good for us, things like drinking alcohol becomes a huge problem when people get stressed. Sometimes it moves on to illicit drug use to help when they get stressed. You can also end up binge eating when you're stressed and end up hurting yourself that way. Some people actually end up in the emergency room thinking they're having heart attacks because of the intensity of the stress that they're actually dealing with.

Interviewer: So any tips on reducing the bad stress and staying healthy under stress that's good, the good way to do it; the good way to reduce stress?

Dr. Jason Hunziker: Yes, good healthy coping skills. So I think again, this is a personal choice; everybody has things that they like to do that help them refocus and calm down. Some people love to sit in front of the television and watch a movie and that just takes away everything for them and then they're good to go. Other people listen to music and they'll sit in their room listening to their iPod for a little while. Some people take a bath and that is very relaxing. Others will go for a walk and that helps them unwind and helps people rethink. I know people who end up in the gym and work out intensely and that just helps them refocus.
Eating well is going to help you de-stress, sleeping well is going to help you de-stress. So ultimately whatever it is that you enjoy doing can help you de-stress. You just have to give yourself the time to do it.

Interviewer: So it sounds like it's different for each person.

Dr. Jason Hunziker: It definitely is different. But I think that the concept is the same. We find that thing that we enjoy and then we use it to help us deal with everything else that's really causing us a problem.

Interviewer: Any final thoughts?

Dr. Jason Hunziker: I think it's really important that every day you take the time for yourself. You have 15 to 20 minutes where you sit and do that one thing that you love to do so that it helps you stay focused and helps you stay mentally well.

Announcer: We're your daily dose of science, conversation, medicine; this is The Scope. The University of Utah Health Sciences Radio.

Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Scot: Question for you, Dr. Tom. Can I call you Dr. Tom?

Dr. Tom: You can.

Scot: All right. Dr. Tom, so a couple of weeks ago ex-president Bush goes in for a routine physical and ends up walking out with a heart stint because of a stress test. Now I've been to a lot of physicals. Other than turn your head and cough, other than asking me a few questions and looking in my ear, I've never been put on a treadmill for a stress test. This doesn't sound like a typical physical.

Dr. Tom: Now Scot, if you were going to the doc maybe 25 years ago, it's possible they could've offered you an annual treadmill test.

Scot: Really?

Dr. Tom: They used to do that. They used to do that.

Scot: It's not standard anymore but they used to?

Dr. Tom: Pretty much not standard unless you have a reason to do it. It's really interesting because you would think if I put you on a treadmill test and ran you, then if that turned out great that would mean that you didn't have coronary artery disease. Well, it turns out if you're a healthy person that test doesn't really add anything and it can actually complicate the issues.

Scot: How does it complicate things? I don't get that.

Dr. Tom: It's complicated because you have to test results in the context of the person who's in front of you. So if you have chest pain, you come in and you tell me, "Man, I ran a mile and I was way more short of breath than I usually am or I was actually having this funny tingling feeling in my arm," the test can really help me back up the fact that I think you may have a problem. So it gives me more ammunition to maybe say, "You know what? I need to put you in the cath lab and do an angiogram and see if those arteries are actually blocked."
But that same information isn't very reliable when you're normal. It doesn't add much to the examination and it can, in fact, complicate things. There's such a thing as a false positive result on a test so it's possible that a certain, small percentage of patients, that they would get on that treadmill, they would be totally healthy without symptoms and they would run and do well and you would have an abnormal finding that would then lead you to end up in the cath lab, which is not a completely un-risky procedure and find out you had normal coronaries. And that's really why we don't do those treadmill tests on everybody that comes into the office on an annual physical for screening.

Scot: Gotcha.

Dr. Tom: So we don't really know exactly what transpired between the physician and President Bush. We just don't know. So it's possible he had some minor symptom that made them think, "You know what? We really ought a put you on a treadmill." In fact, with people that are athletic and are doing well, they are basically doing their own stress test everyday. So, if they were not having symptoms there's really not any added advantage, most studies would suggest, to doing an onsite treadmill test for screening.

Scot: What about somebody who's not healthy and they're just like, "Eh, I just want to make sure everything's okay. Give me that stress test"?

Dr. Tom: That's great. I get that occasionally where I'll have a fairly sedentary individual who then wants to lead the scouting troop up to King's Peak and that's the gentleman I'm going to put on the treadmill and see how he does before I send him off with the scouts, so that the scouts don't have to carry him back.
But I think for the purpose of people that are going in for their annuals, I would say that you don't ask for a treadmill test if you're feeling normal. You can discuss it with your doctor, but anymore we use that test when we have a suspicion of coronary artery disease where we're worried about it. We don't just screen with it. That is, we don't just put patients on the treadmill test just on an annual basis.
We're your daily dose of science, conversation and medicine. This is The Scope. University of Utah Health Sciences Radio.