How Mindful Meditation Impacts Surgical Patients

It is normal for one to be anxious before and after undergoing a serious medical procedure or receiving a life-altering medical diagnosis. But, these feelings should not have the power to affect the outcomes of these events, right? As it turns out, they very well might. Patients who come out of surgery with depression or anxiety may often require additional care, longer rehab, and have more complications during their recovery. Studies that have been recently conducted have been able to link reduced levels of stress, anxiety, and depression in surgical patients who practice mindfulness meditation, which therefore creates a positive mindset prior to surgery, and can lead to significant improvement in recovery time and outcomes post-op. These findings support the ideology ancient Buddhist traditions created in regard to the practice of mindfulness meditation. To further investigate these claims, this paper strives to examine the connection between how mindfulness meditation impacts surgical patient’s mindsets before and after surgery and how this can affect recovery.

Meditation is defined as the act of giving one’s attention to only one thing, either as a religious activity or as a way of becoming calm and relaxed. Specifically, mindfulness meditation, also sometimes referred to as Insight Meditation or Vipassana Practice, is believed to have been created by Buddhists over 2000 years ago in India. This form of meditation is known to be closely linked to Buddhist theology as well. This practice involves creating and bringing focused psychological attention to both the internal and external situations occurring in the present moment; like concentrating on simple physical sensations such as breathing, sitting, or eating. One commonly used methodology involves using one’s own imagination to take a ‘mental scan’ of the entire body for awareness of any and all physical sensations without judgment. It begins at the head and slowly progresses down the body until one reaches their toes. Another type of mindfulness meditation practice may incorporate ‘guided imagery’ techniques in a clinical setting, like after surgery, in which a patient visualizes their own recovery and healing, and affirms thoughts of positivity regarding the management of their illness or pain. Incorporating these simple techniques into one’s post-operative routine may allow patients to become more aware of their own bodies, and therefore envision an enhanced and better recovery for themselves.

By having the ability to influence the psychological state of patients, mindfulness meditation may also be able to address surgical complications such as reduced functioning and pain through the reduction of stress, anxiety, and depression, which can be serious factors in determining the rate of recovery. It has been found that the psychological state of patients has a strong correlation to an early predicted recovery time, although there have been some conflicting reports on this matter regarding study structure which may affect the ability to confidently gather and report findings. Research has found that patients who have experienced stressful situations on a regular basis had wounds that took significantly longer to heal than patients who did not experience high amounts of stress as often. In addition, stress can also increase a patient’s chance of getting an infection. In multiple studies conducted with human patients as well as lab animals, it was found that those with symptoms related to depression and/or high levels of stress were more likely to have an infection or infection-related complication post-surgery, and have a longer hospital stay or readmission. The use of mind-body therapy, like mindfulness meditation, as a nonmedicinal additional approach to surgical recovery, has been linked to significantly improved levels of anxiety, pain, distress, and fatigue due to the optimism and positive thinking it creates in patients. Simply engaging the relaxation response on the brain through meditation can reduce the stress response, which temporarily changes the activity of certain genes in ways that may benefit health.8 Simple implementation of this practice into recovery time of surgical patients, or even before scheduled surgery can have significant positive effects on multiple bodily systems and functioning that can improve their health and body from the inside out.

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Beyond this, more changes in the brain can be seen. Anxiety and stress together are key factors in triggering depression, and mindfulness meditation can alter one’s reaction to those feelings. Dr. John W. Denninger, director of research at Benson-Henry Institute for Mind-Body Medicine explains that 'Meditation trains the brain to achieve sustained focus, and to return to that focus when negative thinking, emotions, and physical sensations intrude -- which happens a lot when you feel stressed and anxious”. Practicing mindfulness meditation has been found to change certain regions in the brain that are specifically connected to depression. For example, some scientists have shown that the Medial Prefrontal Cortex (mPFC) becomes hyperactive in individuals who are depressed. This Medial Prefrontal Cortex is frequently referred to as the 'me center' because it is where individuals process information about themselves, such as worrying about the future and/or dwelling on the past. When individuals become stressed about life, the Medial Prefrontal Cortex goes into overdrive. Another major part of the brain that is linked to depression is the amygdala, or 'fear center.' This specific part of the brain is responsible for the “fight-or-flight” response that is activated when an individual experiences fear and/or [6]possible imminent danger, which triggers the adrenal glands to release the stress hormone cortisol. Sending the mPFC region of the brain into overdrive can lead to more worrying and anxiousness, and so can creating more stress in the amygdala section of the brain. which as a result can “shut down” or cause bodily functions to focus more on protecting themselves rather than recovering.

These two regions of the brain play off of each other to create and cause depression. The “me center” is agitated reacting to stress and anxiety, and the “fear center” response creates an increase in cortisol levels to “fight” a danger that is not real but only made up in one’s own mind. Research has found that mindfulness meditation aids in breaking the connection between these regions. 'When you meditate, you are better able to ignore the negative sensations of stress and anxiety, which explains, in part, why stress levels fall when you meditate. One other way that mindfulness meditation can help the brain is by protecting the hippocampus, which is an area of the brain involved with memory. One study found that individuals who practiced mindfulness meditation for thirty minutes a day for eight weeks were able to increase the volume of grey matter in their hippocampus, which can lead to increased control of emotions, memory, sensory perception, and self-control.These findings attempt to explain physiological reductions in negative functioning of regions of the brain and increase positive functions, which are all evidence of relaxation and benefits experienced during mindfulness meditation.

In conclusion, since mindfulness meditation has begun to be more widely practiced and adopted in Western society, it has also become more frequently used as a clinical tool. In surgical settings, it has the ability to reduce pain, anxiety, and depression, improve contentment and optimism, a patient’s psychological state, and can decrease the amount of recovery time needed post-surgery for individuals. Specifically looking at regions of the brain that control stress, anxiety, and emotions, consistent practice of mindfulness meditation before and or after surgery has the ability to reduce cortisol levels in the amygdala, increase grey matter in the hippocampus, and reduce levels of hyperactivity in the Medial Prefrontal Cortex. Beyond the physiological effects mindfulness, meditation can create, it can also benefit individuals who may be seeking relief from mental or physical stresses created during the time of their hospital admission. More research and development are needed to establish reasonable standardized treatment programs. Although there are mixed opinions about the practice of mindfulness meditation, it may be likely that in the future, medical practitioners will view and utilize it as an effective therapeutic option in addition to, or instead of its pharmacological equivalent.