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Mindfulness and Stress Reduction

March 24, 2014 10:59 AM with Dr. Robert Farra

Mindfulness Based Stress Reduction teaches patients to use the wisdom of their bodies to help them cope with the stressors of life, ranging from chronic physical illness or pain to negative thoughts and feelings about oneself. Mindfulness helps people increase their awareness about where their thoughts and attention are focused and to work toward keeping their focus in the present moment. Dr. Robert Farra, Director of NorthShore Solutions for Depression and Anxiety Program, will answer questions about mindfulness and mindfulness based cognitive therapy and what it can do for those suffering from depression, anxiety or other issues. Submit questions early.

Brenna (Moderator) - 10:54 AM:
Our chat is scheduled to begin in 5 minutes. You can submit questions now or at any point during the chat.

Brenna (Moderator) - 11:01 AM:
We are a little delayed. We ask for your patience while we address a slight technical issue.

Dr. Robert Farra (NorthShore) - 11:06 AM:
Good morning everyone: I’m Dr. Bob Farra, director of the adult mood and anxiety disorders program, Solutions, at NorthShore, Department of Psychiatry.

Dr. Robert Farra (NorthShore) - 11:06 AM:
What I thought I would do today is to share some thoughts about what mindfulness is and how one key understanding of mindfulness is taught and practiced in our Mindfulness Based Stress Reduction program I've been teaching for the past six years in the department of psychiatry, then I’ll be happy to take your questions.

Dr. Robert Farra (NorthShore) - 11:07 AM:
By way of a little history (MBSR) was first developed by Jon Kabat-Zinn in 1979 at the University of Massachusetts Medical Center. In 1992 it was the subject of Bill Moyers’ very interesting 5-part PBS documentary series Healing and The Mind. The development of the MBSR program is the subject of Jon Kabat-Zinn's best selling book, Full Catastrophe Living.

Dr. Robert Farra (NorthShore) - 11:07 AM:
Mindfulness based stress reduction has been shown to be effective in many research studies, helping people with chronic illness or pain, high blood pressure, fibromyalgia, cancer, heart disease, asthma, GI distress, skin disorders, and many other medical conditions.

Dr. Robert Farra (NorthShore) - 11:07 AM:
Mindfulness has also been shown to be effective with anxiety, depression, fatigue, sleep disturbances. Now, to your questions.

  Jayme (Romeoville, Il) - 11:09 AM:
I suffer from anxiety and depression and currently on medication as well. How will this help? I'm looking for other ways to control and beat them.
Dr. Robert Farra (NorthShore)
Mindfulness has also been shown to be effective with anxiety, depression, fatigue, sleep disturbances. Much of therapy can focus on rehashing the past. I spend most of my here doing therapy and have to be very careful to encourage my patients not to simply to rehash the past, but rather focus in the present moment Have you also noticed in yourself that you’ve cultivated the habit of ruminating about the past, focusing on past disappointments, failures and resentments. It may seem that if we have lived this way (that is ruminating about the past and worrying about the future) most of our lives then we are doomed to live this way for the rest of our lives. This is simply not true, but it takes a lot of effort to re-train our minds to be focused in the present moment and this is the work of MBSR.

  Sarah (Lincolnwood, IL) - 11:11 AM:
Hi, 49 yr old woman, waking constantly at 3am with terrible anxiety. Lasts through mid am and wanes. Rest of day am fine, no further anxiety and no issues falling asleep. But 3 am it starts again. Have tried xanax, did not care for it and the only issue really is the early am jolts from sleep. I understand cortisol rises in am, but not sure what can be done. Am really becoming exhausted with poor quality and limited (4-5 hours) of sleep. Anything to be pursued?
Dr. Robert Farra (NorthShore)
Sarah, What goes through your mind at 3:00 am? How much time do you spend in your bed ruminating?

Brenna (Moderator) - 11:13 AM:
Sarah, if you are on the chat, please send through your response to Dr. Farra's question. I will put it through when I receive it.

  Colleen M (Edmonton Alberta) - 11:14 AM:
Can these programs be applied to youth? Do they have to be modified ?
Dr. Robert Farra (NorthShore)
Yes, there are Mindfulness Based Stress Reducation programs for young people. Many schools are using Mindfulness to help students deal with stress.

  Peggy (Schaumburg, IL) - 11:16 AM:
I'm a graduate student here in Chicago specializing in women's mental health, especially as it applies to anxiety and depressive disorders. For one of my classes, I'm focusing on mindfulness as an effective treatment option. What are some important points to know and/or what is important to study and understand about using mindfulness to help treat anxiety or depression? Thank you much!
Dr. Robert Farra (NorthShore)
People who are anxious are usually focused in the future and people who are depressed are often focused in the past. Training the mind to be focused in the present moment is the key to alleviating anxiety and depression.

  Jessica (Chicago, iL) - 11:19 AM:
What can I do to help eliminate the physical symptoms of anxiety disorder? Heart palpitations, feeling like you cannot breathe, digestion problems...etc. It has been really debilitating. Thank you.
Dr. Robert Farra (NorthShore)
John Kabat-Zinn, has written: "Mindfulness is about being fully awake in our lives. It is about perceiving the exquisite vividness of each moment. We feel more alive. We also gain immediate access to our own powerful inner resources for insight, transformation, and healing" (Kabat-Zinn, 1998). Mindfulness is a skill that can be learned and, when practiced in a disciplined manner, can be helpful in reducing depression and anxiety and increasing peace of mind and joy. In our MBSR program I introduce different cognitive practices during the 4 weeks. All of these practices share the same intention: To train our minds to be focused in the present moment.

  @lisameid (chicago, il) - 11:20 AM:
what specific treatments do u offer for PTSD? could you tell us what an initial assessment is like and what ranges of treatments you recommend?
Dr. Robert Farra (NorthShore)
PTSD requires specialized treatment. I don't specialize in PTSD treatment, but we have psychologists here at NorthShore that do. I recommend that you consider calling for an assessment. 847 425-6438

  Donna (Chicago, IL) - 11:22 AM:
I have suffered with depression and anxiety since 1994. I finally started taking an anti-depressant back in 2009 when I saw a Doctor and discussed what was going on with me. I was taking 150 mg of Zoloft which was helping somewhat but my body got used to it. Now I am taking 20 mg of Fluoxetine and it does not seem to be helping. I feel more anxious now. I just don't feel like I will ever be happy and I feel cursed with this anxiety disorder. What should I do?
Dr. Robert Farra (NorthShore)
I recommend you make an appointment with one of our psychiatrists to address your concerns. Medication can be very helpful with depression and anxiety, but it is essential that you meet with a skilled clinician who has extensive experience with different medications. You are not cursed and you can feel better.

  Nadine (Evanston) - 11:25 AM:
Is treatment a replacement for medication? Most often used in conjunction with medication? Have you ever had a patient who was able to discontinue anxiety medication after mindfulness program completion?
Dr. Robert Farra (NorthShore)
The research literature is clear that Mindfulness Based Cognitive Therapy and medication are often the gold standard. Yes, I have had patients who were able to decrease or discontinue their medication, but they were highly motivated to practice mindfulness skills. Sustained practice is key.

  Luisa (Wilmette) - 11:27 AM:
What's the difference between mindfulness and meditation? Does mindfulness include meditation?
Dr. Robert Farra (NorthShore)
There are two types of mindfulness practice, formal and informal. Formal practice includes sitting for meditation for a few minutes each day. Infomral practice focuses on catching ourselves when we begin creating dramas in our mind and relating to them as if they are real.

  Susan (Stilwell, KS) - 11:32 AM:
I have been the caregiver for my 87 year old mother for almost 6 years. She has lived with me & my husband for almost 5 years. How do I deal with the anger & frustration & then guilt for having those feelings for all of these years of taking care of her? I have a full-time job too so I just feel tired most of the time and discouraged. Thank you for your help.
Dr. Robert Farra (NorthShore)
Caring for an elderly parents can result in compassion fatigue. Support from others so you can take a break is essential. You must take care of you, if you are going to care for her.

  Sam - 11:34 AM:
Is mindfulness something you can do on your own? Does it require a medical professional like yourself? What does your program involve? How long does it take? Are they classes? one on one?
Dr. Robert Farra (NorthShore)
The Mindfulness Based Stress Reduction Program for Depression and Anxiety is a four week program (one hour per week for four weeks.) This program teaches participants to use the wisdom of their bodies to help them cope with the stressors of life, ranging from chronic physical illness or pain to negative thoughts and feelings about oneself. Mindfulness helps people increase their awareness about where their thoughts and attention are focused and to work toward keeping their focus in the present moment. Depression is often related to judging oneself about things that have occurred in the past, and anxiety tends to focus on “worst case scenarios” for the future. In either of these situations, all we are doing is increasing our emotional distress over situations that we cannot control or change, all the while missing out on the present moment. In this seminar, a variety of techniques, including relaxation exercises and meditation, will be used to help increase self-acceptance, decrease

Dr. Robert Farra (NorthShore) - 11:35 AM:
The next series of MBSR begins on Tuesday, April 22 6:00-7:00 pm at 909 Davis Street, Suite 160, in Evanston. Most insurance plans cover the cost of the program. To enroll, please call 847 425-6400

Dr. Robert Farra (NorthShore) - 11:37 AM:
During the four session program I teach specific skills which are then practiced. Consistent practice leads to peace of mind.

  Steven - 11:38 AM:
Are there changes you recommend people make while they are undergoing mindfulness program? Are things you can do to make the process easier, more successful?
Dr. Robert Farra (NorthShore)
The recommended changes have to do with how we regard our thoughts and feelings. Thoughts have no intrinsic meaning. We assign the meaning and the associated emotions. And we all have well practiced ways of thinking and emotions and many of these ways become complex patterns that we cling to and dwell on. Now we may not realize how this complex process affects us. Why? Because much of our thinking is automatic. Something happens and we automatically feel upset or angry. Through Mindfulness practice we learn how to live more consciously and get in touch with these recurring patterns.

  Beth - 11:40 AM:
What would your recommended meditation look like? Do you encourage music? Quiet? Dark room? Or is it different for everyone?
Dr. Robert Farra (NorthShore)
In our program I teach many different types of meditation. Participaants are encouraged to practice different ones until they find one they like. There is a free app for Iphone and Android phones called Stress and Anxiety Relief. This app helps us focus on the breath as a way of quieting the mind.

  Christine (Chicago) - 11:44 AM:
are there any books that you recommend, so we can get more info about mindfulness?
Dr. Robert Farra (NorthShore)
John Kabat-Zinn has written several very good books on mindfulness. You can Google Mindfulness Books by him and consider ordering one.

  Beth - 11:46 AM:
What are different types of meditation? I didn't know there were different types. Is yoga considered medititation?
Dr. Robert Farra (NorthShore)
There are many different types of meditation. For example, try eating a meal and do nothing else but taste each bite. Don't watch TV, be on your phone, or engage in conversation. Just eat slowly and taste each bite. There are several types of yoga that include meditation.

Brenna (Moderator) - 11:49 AM:
There are 10 minutes left in this chat. Please submit your final questions.

  Bobby - 11:50 AM:
What would say is the hardest part of mindfulness for people? What part of the process do people have the most difficulty with?
Dr. Robert Farra (NorthShore)
Maintaining present moment focus.

  Didier - 11:52 AM:
I have a very "reactive" stomach. When I'm nervous about work? Or nervous about anything, which seems to be my natural state, I have GI issues. Could this help? Is addressing an issue like that something insurance would still cover?
Dr. Robert Farra (NorthShore)
Yes, mindfulness can help with GI problems. We have a psychologist here who specializes in GI and she uses mindfulness. Here name is Dr. Alison Reynard.

  Bobby - 11:56 AM:
How long does it take most people to be able to maintain that focus? How long until people really start to notice a difference?
Dr. Robert Farra (NorthShore)
Some of us have very bad thinking habits, so we really have to focus our attention. Many people notice a difference in four weeks of practice.

Dr. Robert Farra (NorthShore) - 11:58 AM:
Thank you all for attending today and I wish you well. Dr. Farra

Brenna (Moderator) - 11:58 AM:
Thank you for your participation in today's chat. For more information on the Mindfulness Based Stress Reduction Program for Depression and Anxiety, click here.

This chat has ended.

Thank you very much for your participation.