Health & Exercise Forum

Special Feature “ Health & Exercise Forum” with Geisinger Commonwealth School Of Medicine – The third Monday of every month! 

Guest Columnist: Kathryn Schmidt, MD

Personal Bio: Kathryn received her medical degree from Geisinger Commonwealth School of Medicine in 2019 and is now an Internal Medicine resident at University of Utah Health in Salt Lake City. She loves her program and her new city, both of which allow her to optimize her wellness, with easy access to skiing, hiking, and other outdoor activities. Prior to medical school, she attended the University of Wisconsin-Madison for her undergraduate studies and Northwestern University where she completed a post-baccalaureate pre-medical and health program. Throughout school, she worked as a research assistant, first with stem cell transplant recipients and women affected by gynecological cancers, and then with solid organ transplant patients. During medical school, she served as a volunteer at the Care and Concern Clinic, as well as at an organization called Pathstone, acting as a mentor to men and women who were transitioning back into the community after having spent time in prison. During her last year of medical school, she received a global health scholarship that allowed her to teach English in Thailand, with an emphasis on preventative health care topics. She has joined the global heath track within her residency program and hopes to continue to stay engaged in global healthcare throughout her career. When not working, she likes to kick-box, ski, hike, write, and be in the company of good friends or family, whether that be taking a weekend camping trip to a new place or just having a board game night. Something that makes her really happy is traveling… she has been to all 7 continents and is always ready for the next adventure!

You can actually worry yourself sick

Most people have heard the expression, “worried sick,” but did you know that you can worry enough to the point where it results in emotions that leave you physically ill? For the normal person, this isn’t good, but for the cancer patient, this is just downright dangerous. During my undergraduate education at the University of Wisconsin-Madison, I worked in a research lab that examined various predictors of recovery from cancer. Specifically, we examined the extent to which mood disturbance impacts cancer patients’ recovery following hematopoietic stem cell transplantation (HSCT), which is just a fancy term for a medical procedure in which a donor’s stem cells can be given to a patient suffering from certain cancers of the blood or bone marrow, like leukemia or multiple myeloma. Without getting into the complexity of the study, at the most basic level, we wanted to find out if patients who found meaning in their illness, didn’t avoid unwanted thoughts and emotions, and generally felt less depressed prior to transplant had more successful recoveries and stronger immune systems post-transplant. 

Our study results echoed the conclusions of similar studies conducted prior to ours, demonstrating that there is indeed crosstalk between our psychological states and the neuroendocrine and immune systems, or in other words, our mental state can affect our physical state. 

In patients undergoing HSCT, this is particularly salient, given the critical role of immune restoration in preventing recurrence of cancer, reducing complications, and ensuring survival. Distress, depression, and anxiety have been associated with a downregulation of immune responses relevant to tumor containment among cancer patients, and depressed mood has been linked to relapse and poorer survival following HSCT.¹ So now that we know these things, if you are a cancer patient, fighting for your life, the importance of being happy is no longer just for your sanity, but is quite literally one way to increase your chances at a successful recovery. Interesting, right? But how does this apply to you? Well, you don’t have to have cancer for depression or other emotions to weaken your immune system. This basic concept is applicable to all of us in our everyday lives, and this link between the mind and body may be more powerful than you think…especially during this COVID-19 Crisis!

Here are just a few examples of what I’m talking about…

• Stress can suppress the immune system and over a long period of time, can lead to damaging levels of inflammation, increasing the risk of coronary heart disease and type 2 diabetes.² … eat well, get adequate sleep, practice good hygiene and exercise.
• Social isolation can be a powerful predictor of poor health. One study found 209 genes distinguishing lonely people from sociable ones. While the genes of the lonely people were associated with an inflammatory response, the genes of the sociable ones were associated with an anti-viral response.³  …use technology to maintain social interaction with friends and loved ones.
• Women with early-stage breast cancer who completed a ten-week stress-management program had decreased inflammation, less metastasis (spreading of the cancer), and were better able to fight their tumors, as evidenced by certain physiological markers. Women who only attended a one-day educational seminar did not have the same benefits.⁴  …practice relaxation techniques such as Progressive Muscle Relaxation (PMR) with the help of YouTube videos

Mood Matters

Most of us are going through a roller coaster of emotional states as this storm –called COVID-19 – continues to gain momentum, with global impact. Millions of people are experiencing major life changes. If this resonates with you, you are not alone. People have been self-quarantining or socially isolating for various amounts of time. With the cancellation of planned trips and weddings, the closing of schools and colleges, and mandated work-from-home arrangements, it is easy to be discouraged, especially given that we aren’t yet seeing the light at the end of the tunnel. While each person will respond differently to the challenges we are facing, fear and anxiety seem to be two feelings commonly cited during this difficult time. 

While there is no perfect solution, there may be some helpful things you can do to feel more in control of your day-to-day emotions and general well-being. Different things work for different people, and there isn’t any single, correct way of doing things, so I would recommend getting rid of “should do’s” and expectations. Collectively, we need to cut ourselves some slack and realize that this is a process of trial and error. My hope is that we can feel a sense of togetherness and global solidarity despite physical isolation, understand how to continue living in this very unusual and weird time, and ultimately, find some peace among the chaos. 

We can’t control everything but we can try to control our psychological state and not allow negatively affect our physical health and immune systems, and if we are sick with something serious, we need to do everything in our power to give ourselves the best fighting chance at recovery. Just knowing that mood and psychological well-being affect our physical state is motivation in itself to decide that we are going to choose happiness. This is not to say that you can’t ever be in a bad mood… you can! We all have bad days, but we should work harder to not let our bad moods consume us. 

NEXT WEEK: Part 2: Tips for Being Happy & Healthy During COVID-19 Crisis

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.