Tuesday, May 26, 2009
As you know from reading this blog, last week I was in San Francisco attending the American Psychiatric Association's annual meeting as a journalist. What I didn't report was my biggest knock-me-over-with-a-feather moment. Allow me:
On Thursday morning, I listened to Dean Ornish MD of UCSF. Dr Ornish is a celebrity doctor and author known for promoting smart lifestyle choices as the key to good health. His recommendations are all grounded in rigorous research, much of it his own. For instance, in a 1998 study published in JAMA, Dr Ornish found that patients can not only stop the progression of heart disease through lifestyle management, but can actually reverse it.
In fact, smart lifestyle reliably works across a range of illnesses (including depression), and can often replace invasive and costly treatment (or at least make the treatment work better). The catch is you have to do it, and therein lies the problem. "What's sustainable," Dr Ornish said, "is not fear of dying but joy of living."
Hold that thought.
Dr Ornish is no stranger to depression, having experienced a severe episode that sidelined him from college. Loneliness and isolation, he said, increases mortality 3.7 times. Depressed individuals are more likely to over-eat, smoke, drink, and work too hard.
You would think that making a few simple changes would be easy, right?
"'Dean, you don't get it,'" his patients told him. "'These behaviors get us through the day.'"
Getting through the day anyway they could was more important to them than living to age 86. In essence, these people could see no benefit to giving up smoking if it meant losing their cigarette-smoking friends, especially if there was nothing to replace those friends.
Meanwhile, the research on the benefits of positive lifestyle kept mounting up. In one 2008 study published in PLoS (JA Dusek lead author), researchers found that the relaxation response in trained meditators switched off cancer-promoting genes.
Changing our lifestyle actually changes our genes, Dr Ornish pointed out. But who wants to change their lifestyle? What Dr Ornish finally figured out was that will power was a nonstarter for individuals, as was the motivation to live longer. "Who wants to live long if you're depressed?" he asked.
What works, he said, is joy, pleasure, freedom. Up went a slide of two tango-dancers - Dr Ornish and his wife. Doing the tango was part of Dr Ornish's exercise routine.
That's when the lightbulb went off: Yes, we need to lead disciplined lives, but we are doomed to failure unless we incorporate fun into our routines. On my website are numerous articles about the virtues of good diet, exercise, yoga, meditation, and so on. We know all this stuff works, but what good is any of it if we give up?
Then it occurred to me: None of my lifestyle routines are based on iron will. They all have enjoyment incorporated into them. For instance, my "exercise" is daily walks, water volleyball, and (off and on) dancing. My "diet" is based on my love of cooking, where anything I throw together is both tastier and healthier than restaurant food. My "stress-management" is all about building contemplative time-outs into my schedule. Even my "meditation" has a fun twist - I play (rather badly) the didgeridoo.
Then I flashed back to some of my recent blogs - a whole series on play, a bunch of home-made nature videos. Guess what? When it comes to fun, I am very compliant. My "fun" routines may not be as beneficial as "serious" routines, but they work much better by virtue of the fact that I stick to them.
In the words of Dr Ornish: "Doing the tango makes your brain grow ... Some of the things that are most fun are good for you."
Dang! Why didn't I think of that?