In this episode of the Wellbeing for Real Life podcast Dr Richard Pile and Dr Wendy Molefi talk about stress and what we can do to enjoy better mental health. Topics discussed include what stress is , how some is good for us but too much is not, why it seems to be such an issue today, what happens to our bodies and minds when we are stressed and how we can manage it better to improve our wellbeing.
Richard is a GP specialising in Cardiology and Lifestyle Medicine, and author of "Fit For Purpose: your guide to health, wellbeing and living a meaningful life". Wendy is a GP specialising in Mindfulness. You can find out more about Richard here and Wendy here.
Fit For Purpose is available from Harper Inspire in paperback, e-book and audiobook format, with Richard reading the audio himself. Find out more here. This podcast has been produced the brilliant team at Monkeynut Audiobooks.
Richard Pile 0:07
Welcome to the wellbeing for real life podcast. Have you ever wanted to live life better, but found yourself baffled, bewildered and bored by complicated, confusing and condescending advice? This podcast is the antidote. I'm Dr. Richard Pile Gp, lifestyle medicine specialist, and author of fit for purpose. Each episode, I'm joined by leading experts as we explore different areas that affect our everyday lives. This is the wellbeing for real life podcast. Hello, and welcome to wellbeing for real life. This episode, we're going to be talking about stress and relaxation. I'm Dr. Richard Pile Gp with a special interest in cardiovascular and lifestyle medicine. And my guest in the studio today is my friend and colleague, Dr. Wendy Murphy.
Wendy Molefi 0:56
Hi, Richard, thank you so much for having me with you today.
Richard Pile 0:59
You're very welcome. When the for new listeners to the podcast, could you tell us just a little bit about yourself.
Wendy Molefi 1:04
I'm a portfolio GP and a wellness coach as well as a mindfulness teacher. And basically, that enables me to use all the skills that I've amassed through these specialties to be able to provide more or less of an integrated sort of provision in my clinical provisions.
Richard Pile 1:24
So you are the perfect person to be doing this episode of the podcast with, aren't you?
Wendy Molefi 1:28
Well, you said it.
Richard Pile 1:31
Okay, well, if we start off thinking about stress, a word that we hear a lot these days. Now you and I are both GP's, we both see patients come in to see us in the surgery, I don't know about you, but quite a lot of the time I end up being asked to sign them off, usually with some sorts of stress. So in terms of how youy, your experience of that, how do you feel that that's presenting in the modern world? And is stress a... is stress a real thing? Is it a newfangled invention? What's your view on that?
Wendy Molefi 2:03
Yeah, I mean, we're certainly as GP's seeing quite a lot of it, especially on the back of the pandemic, and it is a real thing, it is a real thing. And I think, as you alluded to is very much a reflection of modern life. But I think let's all forget that stress in itself is actually the body's physiological response to, to pressure, to something that's stimulating us. And evolutionary stress has actually been good for us in that it has allowed us to keep ourselves safe away from danger, as it were. So it is this sort of, I guess, as a humans with our lifestyle, we tend to allow stress to linger. It becomes this chronic sort of problem. And I think that's something that you talk about quite a lot as well, Richard, the sort of chronic stress and the impact of it in our bodies and in our lifestyles.
Richard Pile 2:56
Absolutely. I mean, I agree with you, I think the ability to leap into action and jump out of the way of a bus or run away from a hungry predator is clearly really important. But it's that it's that chronic response and the inflammatory response to it that I think is that is the problem. What Why do you think that we're seeing so many people coming to talk to us about stress? I mean, aside from the the obvious of the pandemic, or do you think there are some factors inherent in modern living, which, which can cause that?
Wendy Molefi 3:25
Yes, I think I mean, there's no denying the fact that there are stresses in life, life comes with its full travails in the sense that people have challenges. There's poverty, there's unemployment, there's all sorts of challenges. And that can, you know, cause a lot of stress in people's lifestyles. But equally, what I tend to see more often than not, is people's perception of the stress or how they relate to the stress, in which case, then, I think they allow the stress to remain and to take control of their lives, as it were, how they view the stress, it's more that sense of perception and their response to the stress, if you like that tends to be more problematic than anything.
Richard Pile 4:10
And I think it's not just so much the stress, but it's, as you say, it's the response to it. I think it depends quite a lot on on the resources that we've got available to us in life. Certainly speaking for myself. In the past, when life's been very stressful, I was fortunate enough to have friends, family, a job, a place to live, so that I could manage quite a lot of stress up to a certain point. But of course, with people with less in the way of resources, it's obviously more difficult. Less in reserve, so more likely to end up causing health problems, perhaps.
Wendy Molefi 4:43
No, and I agree with that. And I think it's about what we're talking about in terms of the things what sort of things is that that people lack? What sort of resources do people need and what tends to cause stress in our lives? What are the typical stressors in our lives so what we perceive as stress? Really, I think that's a big question, what are the main things that tend to lead to stress?
Richard Pile 5:05
And one of the conversations I have with patients is that some people imagine that stress is really just something that goes on inside your head. And if the worst that happens is that you feel anxious, irritable, upset for a while, it's perhaps not the end of the world. But I think something that I think is really important for patients to understand is that actually stress has significant knock on effect on our physical as well as our mental health. Is that something that you talk to patients about?
Wendy Molefi 5:33
Yeah, I think we can't ignore the fact that it goes both ways. Mind and Body, as you've already alluded to, it might be a rather stressful situation might be started by something psychological, something that's happened in a conversation. And then if that is left to linger, it affects the body in that, essentially, what happens during a stress reaction, it triggers off this sympathetic nervous system, whereby it just bombards the body with these hormones, adrenaline, the cortisol,thyroxine, all these hormones that are essentially preparing the body to fight or to flee. So naturally, under normal circumstances, when the stressor is removed, the parasympathetic nervous system kicks in, and that system cuts down so but human nature is such that we leave that lingering on and if this chronic stress maintains that that's what maintains all these high levels of cortisol, all these hormones in the body, which are causes chronic inflammatory response in our bodies, and damages our immune system, it affects our cardiovascular system, and just affects the body in general. So there is that mind body response that we have to be mindful of and actually have a conversation about with our patients when we're talking about stress, not just focusing, I guess, on one element or the other.
Richard Pile 7:00
I think you've raised a really important point there. The inflammatory pathways that may underlie a lot of the modern diseases that we have, such as heart disease, and cancer and depression, and dementia, amongst others. Stress has its role to play in part of that. And we do know that, you know, a stressful life is potentially a shorter life. And now, so far, we we've talked about some quite difficult topics, and you know, listeners might be forgiven for feeling a bit gloomy at this stage thinking, "Blimey, you know, my life is very stressful, and some of the things you've described, are in my life, and I can't really do much about some of those things". So, when it comes to the, I suppose, the counter arguments that are there, the the relaxation techniques, how do you talk to your patients about things that they can do to start to balance this out, or to undo some of the damage that might otherwise be done?
Wendy Molefi 7:54
I think look, like we said, you know, a lot of stuff happens in our lives, we all come from different walks of lives, where there's a lot that happens that we have no control over. But equally, there's different ways of looking at some of these stresses, if you like, if there's a different way of having a relationship, there's a different way of perhaps having a different perspective to things that are particularly stressful. It all starts with maybe addressing the basics, you know, thinking about the basics, and we're talking about sleep, just ensuring that you're sleeping well, you have a really good sleep routine to ensure that you have a restful sleep, and it's during sleep, that the body actually heals from all this inflammatory stuff that's floating about in the body, you're allowing the body to heal and to replenish, and your immunity to regenerate. So sleep is very good. Nutrition certainly is very important these days that we think about food as medicine. So thinking about the kind of foods that we're eating in order to yet again, heal our bodies ensure that we are giving our bodies the natural resources to minimise the impact of whatever's coming at us from all ends. Hydration is very key, it's very important that we're drinking enough water, our body relies quite a lot on water, and over 90% of our bodies is water. So it's important to keep well hydrated. And what else what else, Richard, what do you think?
Richard Pile 9:29
Well, you've made some good points there. I think some of those things, the way I put it to patients is that if stress is essentially or is or causes an inflammatory process, then I encourage people to think about what is anti inflammatory in their lives. What can they do to begin to address some of this and you've touched upon some of them so sleep so fundamentally important movement. And it's interesting, looking at things like food and relaxation exercises and mindfulness which we're going to talk more about. There is objective evidence that if you measure inflammatory markers, doing blood tests in people who are stressed that they are raised, and using some of these measures, including mindfulness as you are no doubt very well aware, you can actually measure a drop in those levels of inflammation as well. And whether that's a direct causal thing, or just an association, it clearly suggests that it's worth looking at. So I talk to people about what they can do, that they have control over. Whereas some of these other things, perhaps are outside of their control. And the pandemic, I think, has been a good example of that. You know, they can't control government policy, whether they have to self isolate if they go on holiday or not, and rules about school and home working and all that kind of stuff but there are little bits each day that people could take back. And sometimes even just five minutes a day, whether that's breathing exercises, listening to some of your favourite music, going for a walk outside, or spending time with your loved ones, even just really, really simple measures like that can can be the start of something really good.
Wendy Molefi 11:03
Absolutely, I couldn't agree more in the sense that that really enables you to see that they actually other good things in life, you know, you can sort of start to appreciate that even though there might be a situation that you have no control over. There are other things, there might be other good things that are happening in your life that you can be grateful for and that in turn, helps you to have a different perspective to what might have felt quite heavy at the beginning, you begin maybe perhaps to reframe it and see it as maybe an opportunity even to approach whatever the problem might be differently. So the sense of having a different perspective to what's happening in your life, it enables you to see that first choice, there's more than one way of responding to a situation. And the old saying also that this too shall pass. You know, stress won't always be there, life is not unfair like that. There are good moments in life to enjoy as well.
Richard Pile 11:13
Perspective is important, isn't it?. Two of the phrases that I had a lot at the beginning of the first lockdown was "this too will pass, ? "we'll meet again", those kinds of things. And it's easy to trot those out. But it is I think it's important to remind ourselves of that. Now you and I are going to talk in much more depth about mindfulness. We do that in another episode of the podcast. But in case anybody was unlucky enough just to only listen to this episode of the podcast, and not the other one. If you were to describe simplistically, how would you describe mindfulness to someone who's listening? And how they might start to explore that?
Wendy Molefi 12:42
Yes, I mean, simply put mindfulness really, it's a cultivation. And I like that word cultivation, a cultivation of where your focus is at, a cultivation of your awareness of your thoughts, your emotions, and what's happening in the body, and how that all relates, as we've already alluded to the fact that stress involves the mind and the body. So through mindfulness practice, you get the opportunity to explore and to come face to face with what really is happening. And in that you can you learn to, I guess, appreciate any patterns, any habitual patterns that might be taking you down certain paths that are perhaps unhelpful, that keep you in that sort of map mode of mind. And without broader awareness, you also learn to sort of know that there's choice in life, because more often than not, we tend to react as the sort of quick knee jerk reactivity to stressful situations. But when you buy yourself a little bit of time by perhaps just stopping, taking a breath, and just pausing. Something clears. You just buying yourself a little bit of time, in terms of, do I respond to this email in this way, or let me just sleep on it a bit and respond in a different way. So it's just about having that awareness to be able to make a different choice, a more skillful choice, perhaps,
Richard Pile 14:24
And people can learn more about mindfulness currently through various apps, a million and one books. If you're going to make a quick recommendation, where would you suggest people have a look?
Wendy Molefi 14:33
Yes, there's lots of books. There's definitely one of my favourite books is by Jon Kabat Zinn, one of the fathers of mindfulness, which is called "Where you are, there you are". It's a very interesting book in the sense that it just, I guess, guides you to the fact that be a bit more present in your life. Yeah, it's that book and many others. And there is a lot of apps out there one of my favourites as well. That one that I use is called Insight Timer. The fact that it explores mindfulness in that sort of a wholesome way, there's lots of different meditations for different tastes, short ones, long ones, spiritual ones, mental health focused ones. So it's just about dipping your toe. And just being curious and being open minded about some of these things. It's certainly no panacea. But equally, it's just a different way of looking at life, of approach in life because we often end up in trouble because we tend to approach things in much the same way. It's just an opportunity to just try something different.
Richard Pile 15:40
I was struck as you're saying that, but even you taking a deep breath in and out, and me doing the same made me feel more relaxed.
Wendy Molefi 15:48
Grounds you doesn't it? It's such a simple physical thing, isn't it?
Richard Pile 15:53
Yes. So I'm very much looking forward to our more in depth conversation about mindfulness. But if we were to begin to wind things up and think about the top tips that you and I have between us to help people, if they are struggling to manage their stress, and if they are, if they'd like to learn more about how to relax, what are a couple of things that you would recommend?
Wendy Molefi 16:13
Certainly that sense of perspective, remembering that "this too shall pass", it's not there forever. So just having that sense of perspective and being able to reframe things and difficulties. Simple breathing exercises, like you're saying, when you just pause and take a breath. Somehow, something dissipates. So simple breathing exercises, in the course of your day, or during a stressful moment, just take a pause, and just breathe. Movement certainly enables us. Changing our physiology allows us, the body, to just have a different sense and feel. So those are the little things I guess I would give as tips.
Richard Pile 16:54
Yeah. They're very good tips. And I'm going to slightly steal and adapt the last one you're given about, about movement as well. I think that sometimes we separate the physical, the mental, the spiritual. And I don't believe you can address those things in isolation. I don't think it works. So I think when we're talking about stress and relaxation, to go back to what you said earlier, it's important to look at that background, how am I sleeping? How am I eating? What are my relationships like and my connections with other people. So I encourage people to think holistically about the whole story. The other thing that I found really helpful when life was a bit tough for us as a family a few years back, was the practice of gratitude as well. And I know it sounds really simple and to be honest, almost a bit twee. But actually, most of us no matter how difficult life is can probably find two or three things every day that we are grateful for, whether it could be for your family, or your job, or the place that you live or the sunrise in the morning or what you just had for breakfast. And some people have significantly, in fact completely turned around their mental health just by starting with that simple practice. And I had it described in an episode of The Freakonomics podcast once about headwinds and tailwinds. If you're a runner running into a headwind, it feels like it's really hard work. And you're looking forward to turning around and coming for home. And I know that you're a runner, so you'll know how that feels.
Wendy Molefi 18:15
Like the wind behind me.
Richard Pile 18:16
And you think oh, when the wind is behind me, that's just going to be fantastic. And yet, within a very short space of time, when you turn around, you're coming home, you forget about the wind behind you. And you start to ruminate about all the other things which are perhaps not as ideal. And we all have tailwinds in our life, particularly, you know, if we're fortunate enough to have a good job and to live in a nice place, which I know not everyone does. But all of those things are just worth remembering. And I've certainly done that in the past and doing that just every day before you go out to work on a Monday morning when you're bracing yourself after the weekend as a GP. I certainly recommend is one of my tips as well.
Wendy Molefi 18:50
Absolutely. It sets the tone for your day.
Richard Pile 18:54
When the I think we're coming to the end of this episode of the podcast, it's been a real pleasure speaking to you. Thank you very much for your top tips. And I'm really looking forward to our further episode of talking about mindfulness together as well.
Wendy Molefi 19:05
Thank you. It's been a pleasure.
Richard Pile 19:08
You've been listening to well being for real life with me Dr. Richard Pile. If you've enjoyed this episode, please give it a nice review and tell other people about it. If you'd like to learn more, my book fit for purpose is out now published by Harper Inspire and available in paperback e-book and audiobook. You can also follow me on Twitter, YouTube, and my website wellbeingforreal.life. This podcast was recorded at Monkey nut Audiobooks. Until next time, take care of yourself.