Laugh More Feel Better

Laugh More Feel Better

by Karyn Busman, RN, MSN, DAIS

smile measureIn today’s fast-paced society, we’re all faced with some degree of stress—cranky customers, irritable bosses, stubborn employees, budgets, dead-lines, telephones, paperwork, a bad hair day, a no hair day. For many of us, a straightjacket may be nearer than we think. “Terminal professional-ism” is a sign of the times. But taking oneself too seriously can have some serious repercussions.1

WHAT IS STRESS?

Stress is the body’s nonspecific response to any demand or pressure and these demands are called stressors. A stressor might be a major life event, such as the death of a loved one or divorce. Stressors could be chronic such as living in an abusive relationship. Stressors can also be occasional, like getting a flat tire in rush hour traffic.2

RESPONSE TO STRESS

Stress requires our bodies to make adjustments physically, psychologically, socially and even spiritually to maintain the necessary balance for survival. Too much stress (distress) can reveal itself in a number of ways. Maybe you recognize these signs in a co-worker, family member, or even yourself:

Psychologically: When we are experiencing stress, we probably feel in-creased anxiety and tension. We may exhibit moodiness, irritability, inability to concentrate, crying, changes in eat-ing patterns, changes in sleeping pat-terns, decreased sex drive, worrying, mood swings, frustration, nervous-ness, and depression. As if that wasn’t enough, we may also demonstrate a negative attitude, low productivity, confusion, lack of creativity, lethargy, forgetfulness, or boredom.2,3 Have you ever had one of those days when you feel so frustrated that you just want to go home and kick the dog… and then you remember you don’t even own a dog!

Socially: We may isolate ourselves from others, feel lonely, or make fewer contacts with friends. Communication may be hampered due to pre-occupation with stressful events or hindered by negative mood swings, such as lashing out at others, nagging, or clamming up.4 We find our-selves thinking or saying, “Just leave me alone!”

Physiologically: Stress affects all our major body systems.3 Breathing tends to be more rapid but shallow, not al-lowing for full air exchange deep in the lungs. The heart rate quickens and blood pressure increases. We may experience a feeling of the heart “racing” or “jumping out of the chest.” The circulatory system shifts the blood sup-ply from the surface of our bodies to muscles and major organs. Have you ever noticed your hands feeling cold, but you weren’t in a cold environment? If you don’t suffer from anemia, or a vascular disease (such as Raynaud’s), your hand temperature is often an excellent indicator of your stress level.

During stressful events, the immune system becomes depressed resulting in an increased susceptibility to viral and bacterial infections.5, 6 Cumulative stressful events can often lead to ill-ness. For example, you get behind on a couple of projects and come down with a cold… a co-worker gets down-sized and you inherit his clients and the next thing you know, you’ve got bronchitis… a virus deletes precious files on your hard drive and now you’ve developed walking pneumonia… then you’re notified that your department is being audited and before you know it, you end up in the hospital on a ventilator!

During a stressful experience, muscles become tense,7 preparing for the “Fight or Flight” response. A person may notice headaches or a variety of muscle aches, clenched jaws or grind-ing teeth, tight neck, shoulder and back muscles and clenched fists. Have you ever found yourself gripping your steering wheel a little too tightly? (Hint: Your knuckles aren’t typically blanched white…) Here’s a quick tip: Note the position of your tongue. If it’s resting in the bottom of your mouth, you’re probably feeling relaxed. If it’s pressed tightly against the roof of your mouth, chances are you’re experiencing some tension.

As for the digestive system, we may encounter a variety of symptoms ranging from cold sores around the mouth to nausea, vomiting, constipation or diarrhea. 8 There’s nothing like numerous emergency trips to the bathroom to keep that cycle of stress building!

Nearly everyone recognizes the rising healthcare costs in this country. These costs put an escalating burden on employers as they cut into the corporate bottom line. Experts estimate that stress related ailments are costing the nation $300 billion every year.9 The good news: Humor is a cost effective and simple way to ward off many of the detrimental effects of stress.

WHAT IS HUMOR?

E. B. White once said, “Humor can be dissected, as a frog can, but the thing dies in the process and the innards are discouraging to any but the pure scientific mind.” Many a scientist has attempted to define humor but few, if any, can agree on a definition. Psychologist Steve Sultanoff, Ph.D. de-fines humor as the intellectual mind-set expressed through the emotional feelings of mirth and the physical expression of laughter. This incorporates the intellectual mindset (wit) with the emotional feeling (mirth) and the physiological expression (laughter).10 I define humor as a feeling of delight, wonder or release that comes from surprise, perspective or insight.11

CONSTRUCTIVE AND DESTRUCTIVE HUMOR

While nothing is black and white, humor can basically be categorized by that which is constructive and that which is destructive. Constructive humor raises self-esteem, is supportive, includes people, reduces tension, con-fronts stereotypical ideas, breaks down barriers, relaxes people, stimulates new ideas, and creates energy and a positive atmosphere. Destructive humor lowers self-esteem, belittles others, excludes others, creates tension, perpetuates a stereotype, creates barriers, creates defensive-ness, closes off creative thought, and focuses on negatives. In its most simplistic form, it boils down to laughing with someone versus laughing at someone. When promoting humor as a means of stress management, the emphasis should be on constructive humor.

According to Dr. Vera Robinson, humor has three functions: psychological, social, and communication.4 Psychologically, humor acts as a major, healthy coping mechanism, relieving anxiety and tension.4, 13, 14, 15 It serves as an outlet for hostility and anger, provides a healthy escape from reality, and lightens heaviness related to minor and major stressors. When people must work on a job that is repetitive, humor can increase the
length of time on task by reducing tension and boredom. Studies also show that humor doesn't detract from tasks requiring increased concentration. Granted, things can sometimes get out of hand. There-fore, it's important for leaders to set the tone for humor while also establishing high expectations of their staff.

Socially, constructive humor lessens the hierarchy between people, establishes rapport, decreases the social gap, and solidifies a group.4, 14 Victor Borge once said, "Laughter is the shortest distance between two people." People that can share a laugh develop a connection. Much office humor is "inside" humor or "you had to be there" humor. While this kind of humor can make folks feel like part of the inner circle, it can also make others feel excluded. Be careful that this humor is used constructively, and not to shut out others.

Destructive humor can increase the hierarchy between people. Teasing and sarcasm can actually be a form of bullying and is witnessed from the playground to the boardroom.4, 14

Much of the conflict that occurs at home and in the workplace results from problems with communication. Humor can help by gaining and hold-ing the listener's attention. Humor can help establish rapport and neutralize emotionally charged interpersonal events. Humor opens the door for communication and conveys in-formation by allowing one to bring up a secretly serious subject to see how it will be received while providing an 'out' such as "I was only joking."4, 11

There are also physiological effects re-lated to humor and laughter. Think back to a time when you experienced a really good belly laugh. While you were laughing, you actually increased your respiratory activity and improved your oxygen exchange.16 During “belly laughter,” air is inhaled deep into the lungs and exhaled forcefully. Smokers or those with a respiratory complaint, such as a cold or bronchitis, frequently experience coughing after laughter. This allows the body to further clear the airways and further facilitate the good air exchange.

In the cardiovascular system, laughter stimulates our heart rate and blood pressure. This increase is then followed by a relaxation phase, decreasing both heart rate and blood pressure.17, 18, 19, 20 According to Dr. Michael Miller, researcher at University of Maryland Medical Center, laughter provides an excellent cardiovascular workout.19 This exercise requires no special equipment and no limit to the number of times it can be used. Great news! You can get rid of those expensive sweater hangers (also known as treadmills, stationary bikes, stair steppers…). You can laugh at your desk, in the break room, in your car— just pick a spot and begin!

laughing pillScientists are making exciting discoveries regarding humor and the immune system.5, 6 For example, studies reveal an increase in Immunoglobulin A, which fights upper respiratory tract infections. Additionally, there is an in-crease in the number and activity of natural killer cells, which attack viral infected cells and some types of cancer cells and tumors. An increase in activated T-cells (white blood cells) is seen, as well as an increase in gamma interferon and an increase in Immunoglobulin G and Complement C. Translated, this means that humor and laughter seem to be producing some very positive effects on our immune systems. They are not a replacement for traditional medicine but can be considered a positive complement to medical treatment.

Other body systems also demonstrate changes during humor and laughter. Muscles briefly tense up but then relax, often resulting in diminished pain.7 In the sympathetic nervous system, catecholamine production increases, result-ing in improved levels of alertness and memory and enhanced learning and creativity21—and in these times when we’re being asked to do more and more with less and less, who couldn’t benefit from some increased creativity? Stress hormones such as epinephrine and dopamine exhibit a measurable drop.4, 14 Laughter stimulates both sides of the brain at the same time, coordinating all the senses and producing a unique level of consciousness and a high level of brain processing, as well as improving recall.22 Internal organs are massaged, so that laughter, like walking, can improve digestion.23 Dr. Lee Berk, psychoneuroimmunologist at Loma Linda University, said, “If we took what we now know about laughter and bottled it, it would require FDA approval.” Any miracle drug that could do all this would cost a fortune!

No one suggests that you attempt to be a stand-up comic or laugh constantly. It is important, however, to attempt to use humor routinely. Whatever forms of humor you choose, it’s important to practice them on a regular basis. When humor happens by accident, there are positive benefits. There are too many rewards, however, to let humor happen strictly by chance. Don’t let stress come between you and the realization of your goals. Put your stress in check by creating a humor habit— jest for stress!


REFERENCES

  1. American Psychological Association. Stress statistics. (2014). http://www.statisticbrain.com/stress-statistics
  2. National Institute of Mental Health. Fact Sheet on Stress. http://www.nimh.nih.gov/health/publications/stress/index.shtml
  3. University of Maryland. Stress. (2013).http://umm.edu/health/medical/reports/articles/stress
  4. Robinson, V. (1991) Humor and The Health Professions. The Therapeutic Use of Humor in Health Care. 2nd ed.. Thorofare, NJ: Slack Publications.
  5. Bennet, M.P. (2003). The effect of mirthful laughter on stress and natural killer cell activity. Alternative Therapies. 9(2) 38-44.
  6. Kielolt-Glaser, J.K. McGuire, L., Robles, T., & Glaser, R.(2002). Psychoneuroimmunology: Psychological influences on immune function and health. Journal of Consulting & Clinical Psychology., 70, 537-547.
  7. Paskind, H.A. (1932). Effects of laughter on muscle tone. Archives of Neurology and Psychiatry., 28(3), 623-628.
  8. Bhatia, V. & Tandon, R.K. (2005). Stress and the gastrointestinal tract. Journal of Gastroenterology & Hepatology. 20(3), 332-339.
  9. The American Institute of Stress. Stress is killing you. http://www.stress.org/stress-is-killing-you/
  10. Sultanoff, S. (1994). Exploring the land of mirth and funny: A voyage through the inter-relationships of wit, mirth, and laughter. Laugh It Up, Publication of the American Association for Therapeutic Humor (now Association for Applied and Therapeutic Humor).
  11. Buxman, K. (2013). What’s So Funny About… Nursing? A Creative Approach for Celebrating Your Profession. La Jolla, CA: What’s So Funny About…? Publishing.
  12. Sveback, S. (2006). Sense of humor and survival among a county cohort of patients with end-stage renal failure: A two-year prospective study. The International Journal of Psychiatry in Medicine. 36(3), 269-281.
  13. Newman, M. (1996). Does humor moderate the effects of experimentally-induced stress? Annals of Behavioral Medicine. 18(2).
  14. McGhee, P. (2010). Humor. The Lighter Path to Resilience and Health. Bloomington, IN: Author-House.
  15. Hanna, H. (2014). Stressaholic. 5 Steps to Transform Your Relationship with Stress. Hoboken, NJ: Wiley.
  16. Fry, W.F. (1977). The respiratory components of mirthful laughter. Biological Psychology. 19, 39-50.
  17. Tan, S.A. (1997). Mirthful laughter: An effective adjunct in cardiac rehabilitation. Cana-dian Journal of Cardiology. 13(supplement B), 190.
  18. Tan, S.A., Tan, L., Lukman, S. & Berk, L. (2008/2009). Humor, as an adjunct therapy in cardiac rehabilitation, attenuates catecholamines and myocardial infarction reoccurrence. Advances. 22, 3/4.
  19. Miller, M. (2007). The effect of mirthful laughter on the human cardiovascular system. Medical Hypotheses. 5:636-639.
  20. Sugawara, J. (2010). Effect of mirthful laughter on vascular function. American Jour-nal of Cardiology.106(6) 856-859.
  21. Rosner, F. (2002).Therapeutic efficacy of laughter in medicine. Cancer Investigation. 20(3), 434-436.
  22. Bains, G.S., Berk, L., Deshpande, P., Pawar, P., Daher, N., Lohman, E., Petrofsky, J., & Schwab, E. (2012). Effectiveness of humor on short term memory function in elderly subjects. The FASEB Journal. 26(lb834).
  23. Cousins, N. (1990). Headfirst. Biology of Hope. NY: Penguin Books.
  24. Buxman, K. (2013). What’s So Funny About… Heart Disease? A Creative Approach to Coping with Your Condition. La Jolla, CA: What’s So Funny About…? Publishing.

 

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