Dr. L. Matthew Schwartz

by L. Matthew Schwartz, MD, FAAPM&R

Local doctor L. Matthew Schwartz tackles your reader questions about health every two weeks. Please feel free to ask him any question about physical medicine, pain, and integrative holistic medicine or wellness. Send questions to askthedoc@chestnuthilllocal.com.

Olivia G of Wyndmoor asks: “I’m stressed: How can I manage my life with greater ease?”

A: The ubiquitous stress management effort we all make reflects the complexity of life nowadays. If our current Orwellian dystopia is not enough to make us all a little crazy, there are many sources of stress that can be identified and hopefully ameliorated. They say living in the future produces anxiety and living in the past produces depression; being present in the moment is calming striving for our Zen is the Holy Grail.

We need to ask ourselves if we have unrealistic expectations regarding occupational productivity. Do we have fear of the unknown when facing health-related challenges? Do we communicate incompletely in our relationships? If so, we feel stressed.

Do we get enough sleep and exercise, and adequate nutrition? Do we have any unhealthy habits? Many questions about these topics were answered in other “Ask the Doc” features as previously published by the Chestnut Hill Local. See prior links above.

A first step would be asking ourselves a sobering question: Are we spending time doing things to which we are not committed? If the answer is yes, perhaps these endeavors can be abandoned. The next step would be to systematically arrange our “to do list” based upon priority. If something is important and has a due date, it can be considered an “A” priority. If it is important but has no due date, it would be a “B” priority. If it is unimportant but you want to do it, it would be a “C” priority. We ought to focus on our “A’s” first and satisfy our responsibilities before allowing life’s distractions to consume our time. Once most of our “A” priorities are completed, a combination of performing B and C priorities makes life more enjoyable. Making daily lists focuses our attention and keeps us on purpose.

Communicating our authentic emotions and cleaning up misunderstandings allow us to get more deeply and profoundly connected to our friends and family. The fabric of our cultural network is most supportive to us. Sometimes we need to schedule social events because others in our circles may not take the initiative. Reframing an uncomfortable situation permits us to speak to the goodness and equanimity within all of us. Exercising generosity of spirit is helpful. “Flip it, change it, rearrange it” is a fun motto to follow. Focusing on what we have to be thankful for, practicing gratitude, realigns our perspective and leads us to be less critical of ourselves and others.

Relaxation breathing and mindfulness meditation train the body in mind to calm down. These techniques can be employed when we notice internal anxiety. There are many Apps for smartphones that can be downloaded and used daily.

If, after engaging in the above techniques, stress is still problematic and invades our consciousness through the day, we might consider seeking professional advice. Counseling from a licensed clinical social worker is most helpful for those who have pragmatic logistical issues to manage. With anxiety, depression, insomnia, and personality challenges, psychological and psychiatric evaluation is advised.

Some self-medicate with alcohol and some overutilize benzodiazepine medications that are supposed to be used for short-term management of sleep disturbance and anxiety surrounding stressful events. Unfortunately, they are prescribed too frequently and for inappropriately long durations. Benzodiazepines actually worsen sleep by eliminating stage IV restorative sleep. More than 1 alcoholic beverage at night worsens sleep that night. CBD oil can be used to decrease anxiety and improve sleep architecture - it can be procured online without a prescription. It would be advisable to check with one’s physician before starting CBD oil.

Recently, we witnessed the backto-back suicides of Anthony Bourdain and Kate Spade. It is very disquieting to imagine what might have gone on in their heads prior to their taking such extreme measures to suppress their inner demons. It is incumbent upon all of us to perceive and recognize signs of stress among those with whom we come in contact regularly. Piercing the envelope that separates us requires courage and selfless devotion to others. Perhaps it is worthwhile for all of us to consider those within our individual circles of influence who might be hiding out and quietly suffering. Pick up the phone and call now.

Dr. Schwartz practices physical, pain, and integrative medicine in Wyndmoor. He is board certified in these specialty fields. He trained at Columbia University, the University of Pennsylvania, and Thomas Jefferson University. For more, see www.MyHealth360.org