Doctors' Day Special- Lifestyle Diseases in Clinicians

We all are celebrating July 1st as Doctors' Day across the nation to acknowledge doctors as front-line heroes because of the pandemic, for their contribution towards society, for treating and taking care of the community in the best possible way, for selfless service and commitment towards patients as healthcare personnel & in the memory of Dr.Bidhan Chandra Roy as his birth and death anniversary!

But as doctors and health care workers are we celebrating ourselves in its true sense??!!

A 41-year-oldwell-known cardiologist in Gujarat's Jamnagar city who performed over 16,000 surgeries, died after suffering a heart attack at his residence early Tuesday morning!!

(This headline which floated in the newspaper earlier in JUNE was not a good sight & has given a major blow to our medical fraternity!) Let us see a few other statistics...

As per a study, it has been found that 49.2% of doctors were at high general risk for cardiovascular disease. (1)

A study covering 250 doctors and nurses in a medical college hospital close to Chennai found that around 50% of the medical practitioners surveyed were at high risk for CVDs (close to double that of the general population) (2)

A study published in the Journal of Occupational and environmental medicine found that long nightshift work was associated with a 29% increased risk of type 2 diabetes amongst doctors! (3)

The prevalence of hypertension and prehypertension among doctors has increased to 36% and 13% respectively. (4)

The Indian Journal of Psychiatry concluded in a study that 30% of Indian doctors and physicians go through depression, while 17% have experienced thoughts about ending their life. (5)

Almost 80% of doctors especially at the earlier stages of their academics and career face the risk of burnout.

A study found that 52% of doctors are dissatisfied with their work-life balance, and 46% feel guilty about taking time off. (6)

Approximately 1 in 10 medical students,1 in 4 interns, and 1 in 16 practicing physicians report some degree of suicidal ideation! (7)

More than two-thirds of the physicians were sleepless (68.3%) and the majority had stress (93.7%).

The biggest concern which has come across these days is BURNOUT! Burnout is defined as an occupational phenomenon in ICD-11: “Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.

It is characterized by three dimensions which are - feelings of energy exhaustion, increased mental distance from one's job, and feelings of negativism thereby reducing professional efficacy. In simple terms, burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who work with people in some capacity and it is considered as an outcome of long-term exposure to occupational stress.

Tips for clinicians :

It all starts with scene safety: Clinicians should protect themselves. This includes being conscious and up to date with infection prevention and control measures and the appropriate implementation of personal protective equipment (PPE), hand hygiene and waste management of potentially harmful materials. Clinicians should make sure that they are fully vaccinated.

Watch your diet: Consuming everything in moderation, and limiting your salt (less than 5g per day), sugar and trans-fat intake goes a long way in preventing comorbidities, this has been proven to reduce Cardiovascular diseases, Stroke, Diabetes, and a few Cancers. (8.0)

Eating in a sitting position and in silence has a huge impact on our BMI. In fact, studies comparing different eating speeds show that fast eaters are much more likely to eat more and have a higher body mass index (BMI) than slow eaters, on the other hand, slow eating promotes chewing and hence balances weight. (9,10,11)

Do not hesitate to seek help when required: There are a few reasons why doctors hesitate to seek help concerning mental and other ailments which include restrictions to their professional privileges, barriers to career development, risk of having their medical license revoked, etc. But as medical practitioners, one must know their limitations and understand they need to be fit physically, mentally, socially, and spiritually to help patients in the best way possible!

As our thoughts are..so are our feelings, and as our feelings are..so are our actions…followed by habits that lead to our personality. Let us consider a tree as a life source (human life) and for this same tree to reap the best quality of fruits, planters, and caretakers (human beings) should work on its roots. In a similar way to make sure the best quality of life and results; the focus should be directed on creating our thoughts.

Stress: Focus on breathing patterns and stay aware of your presence mentally, at the time of stress. Allow your body to breathe through the abdomen, also known as Diaphragmatic breathing/Abdominal breathing. It is studied that oxygen demand decreases and our body uses less effort and energy to breathe. Diaphragmatic or Abdominal breathing when done properly can lower your stress levels, blood pressure, and heart rate, thereby promoting the body to go to a relaxed state. (12)

Make exercise a part of your routine: Adults should do at least 150–300 minutes of moderate-intensity aerobic physical activity; or at least 75–150 minutes of vigorous-intensity aerobic physical activity; or an equivalent combination of moderate-and vigorous-intensity activity throughout the week, as suggested by WHO. (13) A physician who is mentally alert, energetic, and maintains a healthy weight inspires a certain degree of confidence. Regular physical activity has a host of other health benefits, including improved sleep quality, stress management, cardio-protection, and immune protection, and goes a long way in boosting productivity as a healthcare worker. Being physically active releases endorphins, dopamine, and promotes the expression of brain derived neurotrophic factor (BDNF) that can enhance your sense of well-being and reduces stress.

Talk it out: Find a resilient role model that you feel is mentally strong, this could be a friend, family member, or even a co-worker. Spend time with them and share your concerns, with them. This may help you learn how they respond to challenging situations in their life or simply help you feel better by venting your emotions.

Affirmations & Journaling: Journaling or free writing is one of the most powerful yet overlooked tools for keeping your spirits high. This not only acts as a tracking tool for your daily to-do list but also for your emotions and thoughts! There is no right or wrong way of journaling. You may use it like your personal best friend where you can share your feelings without being judged or may use it to affirm your goals for the day! Affirmations are the continued repetition of certain thoughts over time and are proven to change your brain, your cells, and even your genes, which is done via neuroplasticity, a technique of NLP (neurolinguistic programming) (14)

Suicide: Serotonin plays a key role in body functions like mood, sleep, digestion, wound healing, and sexual desire. It is well-documented that the cerebrospinal fluid (CSF) concentrations of 5-hydroxyindoleacetic acid (5-HIAA), the major metabolite of serotonin, are decreased in individuals who attempt suicide. (15) Hence, probably suicide rates can be decreased by increasing serotonin levels in the body.

Rest is productive: Max Frenzel, AI Researcher and writer states, “Excellent work, particularly of the creative and innovative kind, needs rest just as much as it requires time actively engaged in work. When we rest, our brain is busy consolidating memories and quietly searching for solutions to problems we encounter.” Resting properly should be considered an important part of your life. Productivity is not just about getting results…productivity is about getting the best results you can and being in the best of your form. Listen to the signs your body is giving and take a rest accordingly! Rest should be made non-negotiable and non-contingent but must be scaled and scheduled with a proper mapping window.

Maintain sleep hygiene: Not getting enough sleep drains your mental abilities and puts your physical health at risk. Sleep disturbance impacts hormonal rhythms and metabolism, and is also associated with obesity, insulin insensitivity, diabetes, hormonal imbalance, and appetite dysregulation. (16)

In an adult recommended hours of sleep are 7 or more per night. (16) A review of the study has found that sleeping too little at night increases the risk of early death.

Hence following healthy sleep hygiene is of utmost importance. A few tips to maintain sleep hygiene can be:1) Try and sleep at the same time every day.

2)Stay away from blue screens (mobile, tv & mobile) at least for an hour before going to bed. Blue light disrupts normal sleep patterns.

3)Avoid heavy meals and eat at least 2 hours before your bedtime.

4)Stay away from caffeine, tea, Pepsi, and sharp-tasting foods.

5)Value & prioritize your sleep.

Yoga and meditation: The physical postures during yoga promote flexibility, relieve tension, help release emotions and tension, and promote the release of mood-boosting endorphins. Focusing on the present moment during your yoga practice enhances your awareness, boosts your concentration, and centers your mind.

Express gratitude: Gratitude is expressing gratefulness to the world for what you have. It has been studied that expressing gratitude causes synchronized activation in multiple brain regions, lights up parts of the brain's reward pathways and the hypothalamus, and helps in boosting neurotransmitter serotonin and dopamine, thus increasing the happiness quotient in our lives. (17)

Let us work towards making ourselves the best version by taking precautions for scene safety, following a good healthy diet, seeking help appropriately from our fellow friends, taking adequate rest, maintaining healthy sleep patterns, incorporating yoga, meditation & life style of gratitude. This way clinicians can make themselves healthy physically, mentally, socially & spiritually.

References:

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084548/

(2) https://pubmed.ncbi.nlm.nih.gov/27843828/

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232220/

(4)https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_3143_v1.pdf

(5)https://www.financialexpress.com/lifestyle/health/shocking-study-shows-30-indian-doctors-suffer-depression-80-face-risk-of-burnout/1682216/

(6)https://www.bmj.com/content/378/bmj-2022-070442

(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061474/

(8)https://www.emro.who.int/nutrition/reduce-fat-salt-and-sugar-intake/index.html

(9)https://pubmed.ncbi.nlm.nih.gov/32295057/

(10)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357517/

(11)https://pubmed.ncbi.nlm.nih.gov/30570305/

(12)https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

(13)https://www.who.int/news-room/fact-sheets/detail/physical-activity

(14)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814782/

(15)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276609/

(16)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377487/

(16)https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html

(17)https://www.health.harvard.edu/healthbeat/giving-thanks-can-make-you-happier

Disclaimer: The views expressed in this article are of the author and not of Medical Dialogues. The Editorial/Content team of Medical Dialogues has not contributed to the writing/editing/packaging of this article.