Mindfulness and healthy living

Last updated: June 3, 2022

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Healthcare providers, resident physicians, and medical students are at significantly higher risk of psychological distress than the general population. Almost half of all medical trainees have documented provider burnout, commonly described as feelings of emotional exhaustion, cynicism, and depersonalization. Even more worrisome is that as many as one in ten medical students reported suicidal ideation within the last twelve months. There are numerous interventions that can improve healthcare providers' mental health and sense of well-being and prevent the catastrophic consequences of unaddressed psychological distress. Most importantly, information on self-identification of suicidal tendencies and prevention of suicide must be provided to all students and providers. Additional interventions to promote mental and physical well-being can be implemented at an individual and institutional level. Mindfulness meditation has increasingly been utilized as a fundamental component of these efforts. Mindfulness meditation utilizes techniques such as focused breathing methods and guided imagery to bring the user's attention to the present moment in order to reduce stress and anxiety. Positive long-term physical, cognitive, and behavioral changes have all been shown to occur with mindfulness meditation.

If you are transitioning to residency, see also “Life outside of the hospital.”

Occupational distress, though difficult to define and quantify, is common among healthcare providers and trainees. [1][2]

  • Physicians
    • Satisfied with work-life balance: 46% [2]
    • Met criteria for physician burnout: 38% [2]
    • Positive screen for depression: 40% [3]
    • Suicidal ideation: 7% [3][4]
  • Resident physicians
    • Met criteria for physician burnout: 45% [5]
    • Depression or depressive symptoms: 29% [6]
  • Medical students [4]

Epidemiological data refers to the US, unless otherwise specified.

Research shows mindfulness practice and interventions to enhance nutrition, sleep, and physical conditioning enhance cognitive performance, improve health, and promote a feeling of well-being. [7]

Mindfulness practice

  • Mindful breathing focuses attention on the natural rhythm of inhalation and exhalation.
  • Any physical sensation that occurs while breathing may be used.
  • Common sensations to focus on include:
    • The alternating of coolness and warmth in the nares
    • The sound of air moving in the throat
    • The expanding and contracting of the chest

Scientific evidence for the benefits of mindfulness

Neurophysiology

Cognitive performance

Physical health [8]

Mental Health

  • Decreased depression, anxiety, and social impairment in emergency medicine providers practicing mindfulness [16]
  • Decreased self-reported stress in healthcare workers [17]
  • Improved scores on Maslach Burnout Inventory in healthcare providers [18]
  • Reduced depressive symptoms in patients with major depressive disorders (as adjunctive therapy) [19]

Strong social support

  • Handy tips for staying connected with your classmates
    • Join a social media or in-person group.
    • Organize a meal together (e.g., try new restaurants, cook at home).
    • Celebrate med school milestones!
    • Consider joining a club or a sports team at your medical school.
    • Schedule weekly or monthly get-togethers (take advantage of local events).
    • Consider a pet (if it is not stressful to take care of).
    • If religious, find a local church (or other religious community) to meet others.
  • In the classroom
    • Consider joining a study group or study in proximity to others.
    • Inquire about student body organizations and mentorship programs.
    • Split up tasks with others and pool your results (e.g., creating Anki cards).
    • Don’t hesitate to make an appointment with your Office of Academic Support & Counseling; they can help suggest study strategies and more.
  • During clinical rotations
    • Pursue recreational activities in your free time.
    • Maintain relationships with family and friends outside of university.
    • Check-in with your own self and share these feelings with close friends.
    • Find time for regular fun physical activity (dancing counts).
    • Doing something outdoors in nature can help a lot with stress relief.
  • During away rotations
    • Follow a local area event calendar for events only accessible in your new location; join local meet-ups.
    • Research the relocation area in order to find a space convenient and interests you.
    • Determine what style of living is right for you (e.g., private room/apartment, flat sharing, shared common spaces, etc.).
    • Ask a student at your medical school who has previously rotated there for advice.
    • Engage in conversation and form relationships with members of your care team.

Movement and exercise

Good nutrition

  • Reduced risk of depression with a diet high in fruits, vegetables, and unprocessed grains [24][25]
  • Improved academic performance with consumption of breakfast, regular meals, and fruit [26]
  • Benefits of the Mediterranean diet

Sleep and rest

  • Improved long-term memory [21]
  • Positive impact on academic achievements [29]
  • Self-scheduled breaks decrease the level of fatigue during the workday [30]

Approximately 10% of medical students experience suicidal ideation in the United States and about 50% met the criteria for clinician burnout. [4][31][32]

  • If you are experiencing suicidal ideation, seek immediate care.
    • Residents of the United States
      • Call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
      • Text the Crisis Text Line: Text HELLO to 741741.
    • Directory of hotlines for the world: See “Tips and Links.”
  • It is important not to downplay or dismiss suicidal ideation in yourself or your colleagues.
    • Be vigilant for symptoms of mental health conditions that can increase the risk of suicide: e.g, depression, anxiety, burnout, substance abuse
    • Reach out to a mental health professional.
    • Consider taking an online mental health test (see “Tips and Links”).
  • Find out if your university, hospital, or health system offers health professional-specific resources, for example:
    • Screening, e.g., interactive screening programs (ISP)
    • Crisis resources and counseling services
    • Peer and mentor-based support networks
    • Confidential text or phone hotlines
    • Feedback mechanisms to improve the learning and working environment
  • Social support from peers, friends, and family can provide a safety net, both for prevention and crisis intervention.
    • Friends and peers are frequently the first to recognize warning signs in each other.
    • Do not be afraid to broach these subjects if there is a concern.
    • Do not feel ashamed to be vulnerable in sharing your feelings.
    • Your close friends and peers may be going through similar struggles which can mitigate feelings of isolation.
  • If you require a leave of absence for your mental health, it is best to take it.

Do not attempt to diagnose or treat yourself and do not wait until symptoms are severe to seek help.

If you are a resident in the United States having suicidal ideation, do not hesitate to seek care immediately (e.g., call 911, go directly to the ER or a mental health intake facility). If you feel uncomfortable seeking care in your own health system, go to another health facility, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741).

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