Stress and kidney function and CKD

Can Your Emotions Affect Your Kidney Function?

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Fear and Stress

In Chinese Medicine, it is said that the kidneys are the organ of fear. Meaning that unprocessed fear or fear that is not expressed will be stored in the kidneys. Now, whether you believe in the ancient practice of acupuncture and Chinese Medicine is irrelevant here because there are plenty of clinical studies that show us how chronic fear, which is a version of stress abundant in our modern world, has an effect on our health and may manifest in disease. 

First, let me say that there is nothing wrong with feeling fear and stress, It is a valuable emotional response. If I am out walking in the jungle and a lion jumps out at me, my fear response might likely save my life. The flight or fight response, as it is known, forms part of our DNA back from our days living in caves and hunting animals to survive. These days, work, relationships, our mortgage, our boss, and our families are the lions that follow us around 24/7. This chronic stress/fear response alters the way in which our body produces cortisol, this, in turn, can lead to an increased inflammatory response as well as altering our basic biochemical and epigenetic expression in our bodies that is not conducive to health and healing. So it is when stress and fear become chronic that our health suffers.

The Relaxation Response

Herbert Benson developed a method called the Relaxation Response. This stress antidote has practitioners sit quietly for 20 minutes, filling their minds with a positive phrase or belief and focusing on relaxing their muscles from the feet all the way up to the head. Studies showed that the Relaxation Response was able to help with many different ailments, from high blood pressure to infertility, to rheumatoid arthritis, to pain. 

Relaxation Vs Stress response

Benson took healthy subjects and compared the differences in gene expression patterns between long-term practitioners of the Relaxation Response and nonpractitioners. Then, he put the nonpractitioners through an eight-week training and found that their gene expression profile had changed to substantially resemble that of the long-term practitioners. He then replicated his findings before publishing them. 

Among the genes that changed were those involved with inflammation, the rate at which cells regenerate, and the scavenging of free radicals, which are prime contributors to kidney function and kidney health. “For hundreds of years, western medicine has looked at mind and body as totally separate entities, to the point where saying something ‘is all in your head’ implied that it was imaginary,” said Benson of the study. “Now we’ve found how changing the activity of the mind can alter the way basic genetic instructions are implemented.” The Benson study’s co-author says, “This is the first comprehensive study of how the mind can affect gene expression, linking what has been looked on as a soft science with the hard science of genomics.”

More and more studies show us that stress, loneliness, and depression all alter the gene expressions governing inflammation, cell regeneration, and antioxidant production, all key functions required in recovering optimal kidney function. It stands to reason then that implementing techniques and adopting lifestyle changes that move our focus and attention off these emotional states are key tools in recovering kidney health. Emotions such as stress, loneliness, and depression are insidious in our western culture. 

Stress and its effects on our health and genes

So, what can we do about expressing and reducing these emotions in our daily lives? There are several effective ways to reduce stress. Exercise is one way, but my favorite and one of the most studied and proven ways is meditation.

Meditation

Meditation not only changes the stress hormones and chemicals that our body produces but over time, it changes the way in which our brain perceives and processes stress. This results in a diminished stress response, to what would have previously been perceived as a stressful trigger. Research published in Psychoneuroendocrinology has found that long-term meditation practitioners have a faster cortisol recovery from stress. The findings suggest that practicing meditation can improve the psychophysiological response to stress by reducing self-conscious emotions. The study compared 29 long-term meditation practitioners to 26 matched non-meditating controls. The long-term meditators had been practicing Buddhist meditation for at least three years, with regularity of at least three hours per week.

Gamaiunova and her colleagues examined how the participants responded to the Trier Social Stress Test, a common experimental technique for inducing a stress response, in which the participants were asked at short notice to complete a five-minute speech and a five-minute maths task in front of an unfriendly committee, a camera, and a microphone. 

The researchers found that long-term meditation practitioners had faster cortisol recovery from stress than the control subjects. The long-term meditation practitioners also reported experiencing less self-conscious emotions after the stressful task. This change in emotional perception demonstrates, I believe, how meditation can also have a positive effect on the emotions that we feel such as loneliness and depression. The study shows that meditation is related to the physiological recovery from stress, and proposes an explanation supported by the data: meditators are more prone to use an emotion regulation strategy of acceptance, characterized by non-judgment and receptivity towards their experiences. So, does meditation also alter biochemical markers? If a condition like generalized anxiety (GAD) is successfully treated, relevant biomarkers should change, supporting the impact of treatment and suggesting improved resilience to stress as a result of meditation Practices. 

A study conducted research involving seventy adults with GAD and was randomized to receive either a mindfulness-based stress reduction technique (MBSR) or an attention control class. Before and after, they underwent a stress test. The researchers measured biomarkers, including adrenocorticotropic hormone (ACTH) and pro-inflammatory cytokines. MBSR participants had a significantly greater reduction in ACTH levels compared to control participants. Similarly, the MBSR group had a greater reduction in inflammatory cytokines. These results provide the first combined hormonal and immunological evidence that MBSR may enhance resilience to stress. 

Yoga

Like meditation, there is evidence yoga can reduce our stress levels. 

Yoga and stress reduction for kidney health

Studies have shown that meditation and yoga reduce diastolic blood pressure (the lower range) by 3-8 millimeters of mercury (mmHg), compared with people who engaged in another activity, such as aerobic exercise or relaxation. The same study also found that focused attention and automatic self-transcending meditation styles, as well as yoga, reduced systolic blood pressure (the upper range) by 4-5mmHg, compared with people who were not practicing any kind of meditation or yoga. This is important because reductions in systolic and diastolic blood pressure of as little as 2mmHg can reduce the incidence of heart disease, which is a huge predisposing condition for kidney health. Open monitoring and focused attention meditation and yoga reduced heart rate by three to four beats per minute. This is similar to the effects of aerobic exercise, which reduced heart rate by five beats per minute in one study. Both meditation and yoga decreased measures of cortisol, the hallmark hormone of the stress response.

Loneliness

Meaning: affected with, characterized by, or causing a depressing feeling of being alone; lonesome. Destitute of sympathetic or friendly companionship, intercourse, support, etc.: a lonely exile.

Fast facts about loneliness:

  1. A 2010 survey of more than 3,000 adults in the US found that more than a third of respondents aged 45 and older were categorized as lonely.
  2. Younger adults aged 45-49 reported higher rates of loneliness than adults aged 70 and older.
  3. Lonely adults were significantly more likely to report poor health than nonlonely adults.

New studies are shining a light on the effects loneliness has on the cells of our immune system in a way that increases susceptibility to illness.

A team from UCLA found that people who were lonely had greater levels of inflammation and a weaker immune response than those who were not lonely. This suggests loneliness may be associated with a mechanism known as “conserved transcriptional response to adversity” (CTRA). CTRA is characterized by an increase in the expression of genes that play a role in inflammation and a decrease in the expression of genes involved in the antiviral response.

The researchers, Prof Cacioppo, and colleagues, delved deeper into this study, analyzing the gene expression in leukocytes – white blood cells in the immune system that help stave off infection. Their study involved 141 adults aged 50-68 who were part of the Chicago Health, Aging and Social Relations Study. The team found that individuals who were lonely demonstrated greater CTRA gene expression in their white blood cells than nonlonely individuals. 

The researchers also found that loneliness predicted future CTRA gene expression measured a year or more later. Leukocyte gene expression and loneliness appear to have a reciprocal relationship, suggesting that each can help propagate the other over time. These results were specific to loneliness and could not be explained by depression, stress, or social support.

What does that actually mean? That loneliness potentially has a long-term effect on our immune function for at least a year after we experience the emotions of feeling lonely! That is how powerful and detrimental loneliness can be! This study also sums up my feelings about using things like isolation as a means of control during pandemics.

So, how do we transform the emotions of loneliness?

 

Improving Social Skills – Some researchers argue that loneliness is primarily the result of lacking the interpersonal skills required to create and maintain relationships. Typically, these interventions involve teaching people how to be less socially awkward – to engage in conversation, speak on the phone, give and take compliments, grow comfortable with periods of silence and communicate in positive ways non-verbally.

Enhancing social support – Many lonely people are victims of changing circumstances. These approaches offer professional help and counseling for the bereaved, elderly people who have been relocated, and children of divorced parents. Increasing opportunities for social interaction.

Increasing opportunities for social interaction – With this approach, the logic is simple: If people are lonely, give them opportunities to meet other people. This type of intervention, therefore, focuses on creating such opportunities through organized group activities.

Changing maladaptive thinking This approach might seem surprising, and its rationale less obvious than the other approaches. But recent research reveals that over time, chronic loneliness makes us increasingly sensitive to, and on the lookout for, rejection and hostility. In ambiguous social situations, lonely people immediately think the worst. For instance, if co-worker Bob seems quieter and more distant than usual lately, a lonely person is likely to assume that he’s done something to offend Bob, or that Bob is intentionally giving him the cold shoulder.

Lonely people pay more attention to negative social information (like disagreement or criticism). They remember more of the negative things that happened during an encounter with another person and fewer positive things. Becoming aware of this behavior is key in being able to transform it. When you find yourself in a negative frame of mind, feeling rejected or receiving criticism, catch yourself and say, “This is my perception. Is it actually real?” 

I also urge anybody who feels lonely and isolated or depressed to seek support and help. It isn’t something to be ashamed of, but rather something that can be healed if you ask for support.

Loneliness, I find, is often shifted by finding people and communities that share common interests and goals, but who also support our transformation and growth as a person. I don’t recommend finding other people with kidney disease to hang out with unless they are vested in their personal growth. Otherwise, you are surrounded by people who, maybe like you, feel stuck by the disease or condition and who may derive their sense of identity from being sick. That way of thinking doesn’t support health or transformation; it promotes feeling stuck and sick. 

Practicing Gratitude

How do I get grateful about needing a kidney transplant or going on dialysis? It’s all about perspective. You see, for me, having Multiple Sclerosis (MS) has enabled me to live a life far more in the present moment. I don’t take things for granted like I used to. I travel more (Pre Covid!), have a great career, take more time out for myself, and have met the most amazing people, all of which I wouldn’t have done had I not been diagnosed with MS. Without that diagnosis I would still be working seven days a week, 12 hours a day, stressed out of my brain! MS was my body’s way of slowing me down and making me enjoy life more. I am eternally grateful for that lesson, otherwise, I was running to the finish line of life and I would have got there, exhausted, unfulfilled and probably a decade or so too early! 

gratitude and kidney health

If you still don’t believe me that finding the silver lining to your CKD diagnosis might have some merit, then I highly recommend that you read the book – When The Body Says No, By Gabor Mate. It is an exceptional book about the effects of trauma and how our bodies use disease to communicate with us, especially to say no when we have lost the ability to express that ourselves. Gabor found that many cancer patients, for example, had a reduced ability to express anger. I find in my clinic that MS patients seem to be people pleasers and have a really hard time saying no to others’ requests. In kidney disease, one study found that those diagnosed with CKD were more likely to have certain personality traits namely extraversion and neuroticism. The same study also found that those who had social supports that included a level of affection had better long-term outcomes than those who didn’t. Of course, when we look at the effects of loneliness on health, having supports that make people feel connected, will in turn result in better health outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488553/

Why is extraversion a bad thing? I can only conclude that some extroverts are less likely to express fear, loneliness, and stress in healthy ways. Extroverts, by nature, are more likely to put on a smile even when internally they are struggling, they are also more likely to continue to push through stressful events than take time out, which is more a trait of the introvert. 

Personal Exercise

It’s easy to talk concepts but let’s get practical!  What has your disease done for you? It’s time to get out a pen and paper and answer these questions. And before you answer each one, I want you to take the time to close your eyes and really think about it.

Getting grateful exercise
  1. Who have I had to become as a result of my diagnosis? Have I had to become more vulnerable, a better communicator, more empowered, more decisive?
  2. Who has come into my life or left my life as a result of my diagnosis? How has this been of benefit to me?
  3. How have I changed my behavior as a result of my diagnosis? Is this positive or negative in my life?
  4. If my behavior change has been negative, how would I like to have changed due to my diagnosis? What do I need to do to achieve this? What beliefs, attributes, and behavior do I need to be more aware of and shift?
  5. What are three things that I am grateful for as a result of my diagnosis? 

Write them down. 

I encourage you to keep this paper and review it once a week. I find that constantly checking into the things that I feel grateful for keeps me balanced and stops me from slipping into a victim mentality, that let’s face it, doesn’t help anyone! 

Our bodies are powerful natural pharmacies; how you think and how you feel alters the production of these potent neurochemicals. By getting grateful once a day you help your body to produce healing neurochemicals. That alone is worth the effort don’t you think? Daily gratitude is easy to practice. It is as simple as listing three things that you are grateful for every day. And hey, if you don’t believe me, why don’t you just try it for 10 days? You have nothing to lose.

Your brain on unhappiness

Not only do your genes change with unhappiness, your brain’s wiring changes, too. Jeffrey Schwartz, a neuroscientist at the University of California at Los Angeles, has studied a psychological illness called obsessive-compulsive disorder (OCD). He’s tracked the changes that occur in bundles of neurons in the brain when OCD is treated. Successful treatment resulted, literally, in a rewiring of the neural connections inside the brain. Like a house that adds wiring to the electrical connections that are used most frequently and strips wiring away from neglected circuits, the plastic brain is in constant motion, responding to stimuli by creating new neural pathways. Unhappiness reinforces our unhappy brain wiring and vice versa. Science is catching up to where spirituality has been for thousands of years; the Buddha urged us to maintain a calm state of desireless attention to the present moment, reminding us, “We are what we think. All that we are arises with our thoughts. With our thoughts, we make the world.”

Final Words

Finally, I want to say that I find the patients who get better and defy the medical odds, be it with kidney disease or something else, are the ones who not only manage to change their diets, add in some exercise and take some basic nutritional support, but it is the ones who train their minds to be stronger, who want to change not only physically but mentally and emotionally as well. It is those who see the blessings and the lessons in the seemingly bad hand that they were dealt and who say, “It doesn’t matter; bad things happen. It is what I am going to do with my situation that matters.”

Yes, life can seem unfair and tough at times, trust me I know, but it is friction and resistance that cause us to grow. In a world where we prefer to be comfortable rather than uncomfortable, change is hard. The greatest words of wisdom that I can give you are to embrace the discomfort and make it your friend, step out into the unknown, master your mind, and in doing so, you may just master your life.

Good luck and may the force be with you!

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