The holiday season is a time for celebration and togetherness, but the end of the year can also be stressful. With schedule changes, trip planning and frantic last-minute shopping, tensions run high and personal health and wellness can slip to the bottom of the to-do list. By focusing more on our quality of life rather than our quantity of life and listening to the wisdom of the body, we can learn to deal with stress in a healthy way. This mentality can carry through our lives to help us embrace the end of life when we can no longer continue to heal.
While the colder, darker winter months can cause seasonal depression, Rachel Vreeman, M.D., assistant professor of pediatrics at Indiana University School of Medicine, and her colleague Aaron Carroll have debunked the myth of suicides increasing during the holidays. In 2011, they analyzed studies of suicide trends throughout the years. One study in Japan between the 1970s and 1990s found lower rates of suicides before the holidays, while a U.S. study encompassing 35 years of data showed no increase in suicides before, after or during the holidays.
But natural deaths are a different story—the spike in holiday deaths has been a stark reality to those who deal with death as their occupation: emergency room staff, funeral home directors and clergy members. A national study published in the Social Science & Medicine journal in October 2011 reviewed 57.5 million U.S. death certificates from 1979 to 2004. The study, led by University of California sociology professor David Phillips, found that 42,325 more people died of natural causes during the two-week Christmas to New Year holiday period than expected in a typical winter.
What causes the increase? One emotional explanation is that those who are fatally ill fight to stay alive until they know their family will be gathered and able to say goodbye, in order to gain closure. This suggests something very powerful: We have close connections to the end of our lives.
Barbara Ballard, vice president for hospice and palliative care at WellStar Health System, Inc., says that our fear of dying limits our ability to embrace the end of life. “In order to embrace death as a natural part of life we need to overcome the fear of dying. Our culture does not embrace open discussions about death and we so often view death as some monster to be defeated by state of the art diagnostic tests, medications and surgical procedures,” says Ballard. “We even use language in obituaries such as ‘she lost her battle with heart disease’ or ‘he fought cancer until his last breath.’ With the pronouncement of a terminal illness often comes an uncertainty about what the future holds and this uncertainty can lead to an ever-present fear of dying. Unless we accept the inevitability of death, it will be difficult to enjoy or appreciate whatever amount of time remains.”
The process of accepting this inevitability is different for each person. Norman Cousins, an American political journalist, did research at the University of California, Los Angeles, on the biochemistry of human emotions, which he long believed were key in human success in fighting illnesses. In “Anatomy of an Illness (As Perceived by the Patient),” Cousins tells of how a stressful trip to Cold War Russia in 1964 left him confined to bed by a debilitating illness. He was admitted to a hospital for tests and treatment and was ultimately diagnosed with ankylosing spondylitis, a long-term disease that involves inflammation of the joints. Cousins’ condition deteriorated and he was given a grim prognosis, which, along with the depressing hospital routine, further aggravated his condition.
With permission from his doctor, Cousins moved into a hotel that was less expensive, had better food and allowed him to watch humorous Marx brothers’ movies. He incorporated high doses of vitamin C, which he also used to help battle heart disease. “I made the joyous discovery that 10 minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep,” he reported. “When the pain-killing effect of the laughter wore off, we would switch on the motion picture projector again and not infrequently, it would lead to another pain-free interval.” Cousins survived years longer than his doctors predicted: 10 years after his first heart attack, 26 years after his collagen illness and 36 years after he was initially diagnosed with heart disease.
Cherry Collier, Ph.D., assistant professor of psychology at Life University, agrees that “mind-over-matter” plays a huge role in deciding your destiny. “The mind in and of itself is a very strong tool,” she says. “If you’re thinking about your own death and you’re getting older and you’re concerned and thinking ‘Am I near the end?’ of course that can manifest physically. Anything that is in the mind will [affect] the body. The mind and the body are not separate.”
For Richard Shook, Ph.D., an assistant professor of psychology at LIFE who has worked in the area of death and dying for more than 20 years, true healing comes from embracing death and being open to what you’re feeling about your diagnosis. “There’s a certain duality in that we accept [death] and embrace it or we go on with life, and in our society we’re averse to really grieving,” says Shook. “Even when we don’t have a terminal illness, [death] can have a very healing, positive aspect to it to motivate us, to do things to leave a legacy, to try to do constructive, positive things in life.”
While there is no definitive evidence that thinking positively will reverse fatal diseases or ailments, the objective is to feel better—being able to ease your suffering and enjoy the remainder of your life. Remaining optimistic is the real goal, and Collier says it doesn’t have to seem so unattainable. “Optimism is the belief that things can work out, and because of that belief you move forward. I say that [mind over matter] is strong, and people who have a more optimistic outlook will certainly have a ‘better life.’” From teaching positive self-talk and writing letters of gratitude, to focusing on three good things about yourself, there are many ways to help you stay mentally well. Even exercising, no matter what type and no matter your age, releases endorphins, which change the chemistry in your brain. “It’s up to us to learn to train our minds to focus more on the good. Every day you’re going to hear something that says you can’t do it, and when you hear that you have to learn to redirect,” Collier says.
When faced with a terminal prognosis, especially one involving a specific timeframe, it’s important to really understand what’s been predicted for you by your doctors and then to decide what to do about it. “You need to make sure that you’re paying attention to the diagnosis,” says Collier. “In my father’s case, when he was diagnosed in 1991, they told him he had four weeks to live with a very serious form of cancer. My father didn’t die until 2004, and he didn’t die from that form of cancer.” Her father refused chemotherapy and chose instead to continue doing the things that made him happy. “He decided to really live his life as opposed to being sad,” recalls Collier. “He went out and got another job in his late 60s. He made positive [impressions on] everyone he met. He would drink his gin and juice and tell the doctor that he wasn’t going to give up the things that made him happy.”
Sometimes getting to that mental state can take time and dedication, so Shook works with his patients on meditation techniques. “I think if people really open up to how they feel they can more easily come to more authentic, positive positions,” he says. “Healing can take place even in the face of death, and what I mean by that is the choices you make about how you’re going to live until the time of death, the choices you make about how you relate to friends and family can also have a healing component.”
“Dying is a personal journey, not just a medical journey,” says Ballard. “A person facing a terminal illness has to learn how to die just as they learned how to succeed in all other stages of growth in their life.” Embracing the mindset that death is a natural and healthy part of life is essential to getting the most out of the remainder of your life, and utilizing hospice or palliative care can reduce suffering when you have an ailment, be it temporary, fatal or presumably fatal.
Palliative care has shown great success in improving patients’ quality of life while ailing because it focuses on relieving pain regardless of the diagnosis or predicted life expectancy. Hospice care is generally provided by a visiting hospice nurse in the home, while palliative care is based in an institution and made up of a team of professional medical caregivers like chiropractors and nurses.
Whether palliative care or other therapies are the right path for you, keeping your mind well can be integral to keeping your body well. “By no stretch of the imagination give up—fight to the end. You don’t have to take a prognosis and be gloomy,” says Collier. Really opening up to yourself and close family are very positive ways to finish your life on a loving note. “When people know that death is coming it gives a certain urgency to increasing quality of life,” says Shook. “It’s about learning how to be as open and having as vital a life as possible.”
If you or a loved one is suffering from an ailment, know your care options and seek the help of those who can help to alleviate your suffering. And remember, it’s important to do what you love and makes you feel well even when you’re physically ailing.