A 43-year old man comes into a doctor’s office complaining of lack of energy, insomnia, anxiety, decreased libido, digestive problems, and lowback pain. A vigorous workup uncovers no organic illness. The doctor may prescribe a tranquilizer or stimulant or just tell the patient to relax more. But is this enough?
About seven out of 10 patients doctors see are suffering from such symptoms. And 80% of them have no underlying illness – just chronic fatigue. It’s true that fatigue may be a symptom of organic problems such as infectious mononucleosis, anemia, kidney infection, or hormonal imbalance, but ‘once these have been ruled out, conventional medicine has no answer for what is plaguing the patient.
Here is where the holistic approach – positive wellness – can step in. It starts with the assumption that a person should feel great, and if he doesn’t he has a real health problem. The World Health Organization defines health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” The person who is chronically fatigued is of major concern to the holistically minded doctor, who by intervening early may help ward off real illness later on.
First, it’s important to look at the patient’s lifestyle. Is he getting enough sleep? Is he too sedentary? Or he is compulsively on the go, disregarding his body’s natural rhythms of rest and activity? Is he under too much pressure? Is he on an excitement treadmill? The pressure to seek stimulation in our culture has become so intense that people forget they need to recuperate. Many rush from a hectic office, battle commuter traffic, and arrive home only to turn on the T.V. To keep feeling “up” they need perpetual stimulation. Finally the system breaks down.
The first prescription of the holistic approach is that the patient must not rely totally on prescribed stimulants to ward off his chronic fatigue. Non-pharmaceutical stimulants should also be discouraged; if the patient drinks four or more cups of coffee a day he should be told to limit himself to one.
Secondly, he should try to get off the excitement treadmill. His nervous system was not designed for it. Winston Churchill knew that; he took catnaps every day during World War II. Maybe it’s time our patient took a vacation – not just any vacation but a restful one. Even a day at home might help. At least once a month I take a day off, make no commitments, take the phone off the hook, and let myself recoup.
Something I urge my patients to do is meditate for 20 minutes or so before breakfast and in the evening before dinner. This “healing silence” must be working, because many doctors tell me they are now meditating twice a day, with good results. It’s a great way to do some psychological housecleaning, to let the mind settle down, and reduce stress and strain. I understand some corporations are starting to provide quiet space for meditation and relaxation. Employees come back feeling more refreshed than they ever do after coffee breaks.
Another thing to look at is the patient’s nutrition and exercise habits. Many people suffer from fatigue because they are “sugarholics.” Some overeat and some don’t get enough protein, vitamins, or minerals. Needless to say, excessive drinking and any smoking at all should be firmly discouraged. Patients should be advised to exercise vigorously four or five times a week for at least 20 minutes and to do some stretching or yoga positions for flexibility.
A doctor has a tremendous opportunity to be a catalyst for health. Patients come to him because they are hurting; they’re in a mood to listen. The most persuasive doctor, of course, would be an exemplar of good health: alert, confident, full of energy, free from excesses, satisfied with his work and the direction of his life, and at peace with himself.
Dr. Bloomfield is founder of the Center for Holistic Health in San Diego-and co-author of The Holistic Way to Health & Happiness (Simon and Schuster, 1978).
(credit: MEDICAL WORLD NEWS/ December 11, 1978)