Thoughts: On being less sad

 

I’m not a hippy, but I kinda think like one. I’m a committed practitioner of yoga, believe strongly that mindfulness is core to saving the world from itself, and believe in a poorly-defined yet strongly-felt spirituality that is a strangely-woven tapestry of the dozens of religions and philosophies I’ve encountered during my travels. These characteristics give me a mind-over-matter view of my life.

Yet, I’ve been pretty down for the last few months. Most of my friends have been too, and not just the residents I spend an uncanny amount of time around. At times it’s been easy to sink into a couch and feel sorry for myself, though I can never quite label what it is I’m sorry about. Working hard? A decade of life indicates that’s something I thrive on, not wallow over. Being single? Despite my frequent whining, I’m a diagnosed commitmaphobe who enjoys things the way they are. Winter blues? It’s the mildest winter I’ve ever experienced, and a good chunk has been spent in Australia, Bolivia and Cuba…

While I can’t put my finger on what it is that’s been suppressing my usually (annoyingly) cheerful self, I do know that there are tricks I can use to turn around my mood and get my ass in gear. I’m fortunate to have these tools at my disposal: there are friends of mine, patients of mine, and strangers of course, who just can’t. I wonder if I’ll ever be like them, and worry a little over the unknown characteristics of a disease called depression. But, on this first day of spring, I thought I would share what my friends and I have been discussing quite a lot recently: how to stay positive in an increasingly busy, complex and tragic world.

Our Reptilian Brain: Helpful or harmful?

I’m a firm believer that I should respond, rather than react, to every stimulus around me. Reactions bypass the frontal lobe; they reside in the reptilian brain and amount to being on autopilot. They are easy to have, because they happen without doing anything at all. They are executed by the base of the brain, the same brain parts shared by alligators and owls and, I presume, a tyrannosaurus rex. But a response is different; responses are considered reactions. They are a bit slower, a lot more taxing, and infinitely more useful (unless you’re being attacked by a saber tooth tiger!).

Our reptilian brain, responsible for our survival, is where our primitive drives reside: the three F’s they taught us in medical school (fight, feed, and f…ornicate). They are reactive, emotional and often flood our bodies with hormones and neurotransmitters that jack up our heart rate, blood pressure, and sense of sight. They are prehistoric, intended for survival. They have not evolved to take into account an 80 hour work week, QEW traffic, instant messaging, or my resident pager. And yet, these “modern” stresses have the ability to activate our reptilian brain in much the same way as a bear attack does. This is maladaptive; adaptation takes time.

How do we regain control over this maladaptive reactivity? We practice responding rather than reacting.

When others say or do something, we can slow down my reception, respond to the stimulus, and have a considered output that is more useful than a quick reaction would be. Allowing others to bring me down, I would argue, is immature. It shows a lack of perspective and control over my world. Attitude is relative, of course, and it’s hard to stay positive when surrounded by negativity. And so, I work hard to spend time with positive-minded people. When I start to get into that cycle of negativity, I always ask myself three questions:

• Do I have any control over this situation?
• Is my perseverating motivated by anti-kindness?
• Is there a fresh lens I can view this situation through?

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And finally, when all else fails, I simply say “Can I let this go?” Easier said than done, this often involves using physical activity to stimulate the difficult mental work that goes into letting go. A run, a swim, a yoga session… sometimes, I literally need to sweat it out.

Energy Leadership: Part of the solution

I was recently introduced to the concept of “energy leadership” which I found rather enlightening. It basically outlines different “levels” of response to emotional stimuli. By adjusting your own response to stimuli, you can lead and motivate others around you. Here’s the jist of it:

You can respond to a stimulus with catabolic energy, which is negative, or anabolic energy, which is positive. Anabolic energy is constructive and growth-oriented, while catabolic energy is draining and blinding. Without boring you with research, it seems to be based in science.

Leadership, or the ability to influence someone through an interaction, can be knowing or unknowing, positive or negative. In other words, your own output can affect the output of others, and vise versa. You can also lead yourself, which I find I’ve been having to do more and more these days to maintain my same level of happiness and productivity.

Here are the energy levels:

1. Apathy: “I’m losing. Everything is against me.”
2. Anger: “I want to win, so you have to lose. I will beat you.”
3. Forgiveness: “I win, and hopefully, you win too.”
4. Compassion: “I want to help you win, even if I lose; I am here in service.”
5. Peace: “Everyone wins or no one wins; let’s make lemonade out of these lemons!”
6. Joy: “We always win; everything happens for a reason.”
7. Passion: “Winning and losing are illusions; they are false constructs. We are just being.”

Most health care workers live at level 4 when they are with patients, and in level 2 when they are in the break room. We have bursts of success where levels 6 and 7 are displayed, and tragic loses where we spend time at level 1.

I find I can be very hard on myself, as well as others. This often involves judging my actions and decisions on data that I didn’t have at the time those decisions were made. For example, a CT scan comes back normal and I say “Ah, I shouldn’t have ordered that test, it’s normal!” when really, at the time I ordered it, by pretest probability for X supported ordering the scan. I rarely say “Yes, the CT is positive! Ordering it was such a brilliant move!” Here we can see that I perseverate on the “bad” rather than admire the good.

I don’t want to bore you with what may sound like frilly theory, but I’ll leave you with my assurance that I have viewed my world through a different lens since being introduced to the concept of energy leadership. I find I keep things in perspective, forgive myself and others more often, and take more joy out of the work I do. Energy leadership has joined my self-control repertoire, along with mindfulness techniques and yoga and my strange definition of spirit so that I can be just a little less sad.

If you have techniques that work for you, I’d love to hear about them in the comments below or by phone, email, twitter or facebook. We’re all in this together… to win. (For now, winning is still a construct I very much strive for, but I’m a work in progress.)

Thanks for reading this rather long post… I’ll keep it shorter next week.