The effect of Transcendental Meditation on Chronic Stress
Jaan Suurküla M.D.
In science, stress is defined as a "fight or flight" response. It is a bodily response called forth when the situation appears threatening or more demanding than one can manage with one's ordinary resources (see also footnote 1). Stress is physiological response, whose purpose is to mobilize the reserves of the body. This recruitment of bodily resources is mediated through different mechanisms including stress hormones.
Stress is considered a primitive survival mechanism, that is seldom needed in civilized life conditions. It may therefore appear remarkable that it is a major health problem in modern life. The reason is, as will be explained below, that emotional insecurity and anxiety proneness are major stress-evoking factors.
In chronic stress there is a perpetually increased level of stress hormones.
Chronic stress leads sooner or later to so called burnout. It manifests as psychological and physiological disturbances and ultimately diseases. The pattern can differ somewhat. The symptoms may include psychosomatic disorders (e.g. tension neck, headache, gastritis and irritable bowel), pronounced tiredness, low psychological endurance and concentration ability, memory disturbances, inner tensions, anxiety, sleep disturbances and depression. But before these symptoms, people may have a high stress hormone level for years without being aware of being "stressed".
There is a connection between chronicically increased levels of stress hormones and the so called "metabolic syndrome" that appears as increased abdominal fat, increased blood lipids, tendency for high blood pressure and a tendency for adult onset diabetes (genetic factors determine to what extent these disturbances occur, so all of them may not appear in every case of chronic stress). This syndrome brings about a significantly increased risk for atherosclerotic cardiovascular disease including stroke, angina pectoris and myocardial infarction.
Chronic stress is also associated with an increased risk for abuse of various kinds including, nicotine, alcohol, sedatives and illegal drugs (ALEXANDER CN et al 1944).
Serotonine and Chronic Stress
Serotonine is an important signal mediator in the nervous system. Higher levels are associated with a relaxed and pleasant mood.
Animal experiments indicate that lowered levels of serotonine are related to a chronic increase of the stress hormone cortisol (SAPOLSKY RM 1992, SAPOLSKY RM 1984). Several observations indicate that the same may be true for humans. Among others it has been found that the levels of cortisol are decreased when precursors to serotonine are given to a subject (MAES M et al 1990).
Increased levels of cortisol have also been demonstrated in psychoses, panic syndrome, alcoholism and anorexia nervosa. In all these conditions the serotonine levels have been found to be low.
Serotonine inhibits the activity in a part of the brain called Locus Coeruleus (LC) (ASTON-JONES G 1991). As stress lowers the serotonine levels, the activity in LC is increased (NISENBAUM LK 1991). Increased activity in LC is associated with feelings of anxiety, anger, fear and frustration.
It seems plausible that it is the increased LC activity that is the cause of the unpleasant mood associated with stress.
There seems to be a reciprocal mechanism involved here. Anxiety is psychologically defined as a diffuse sense of being threatened, which is stress-provoking. Anxiety leads to increased stress hormone levels. So when anxiety is provoked for primarily psychological reasons, it increases the stress level. And the physiology of stress in turn increases anxiety through the increase of LC activity.
On the other hand, when stress is primary, it causes increased anxiety that reinforces the stress condition.
This can be summarized in the following diagram (tryptophan, that is mentioned in it, is a precursor to serotonine):
TM gives rise to a positive serotonine balance
TM has been found to lower the cortisol level. A lowering has been demonstrated during TM practice. The lowering is greater in those who practice TM regularly. Both these effect are more pronounced in advanced practitioners (JEVNING R et al. 1992, JEVNING R et al 1978). Therefore it is not surprising that the serotonine levels have been found to increase during TM (BUJATTI M, RIEDERER P, 1976). Regular practice is thus likely to increase the average serotonine level. This is believed to be the explanation why TM has been remarkably efficient in treatment of drug abuse conditions including nicotine, alcohol and illegal drugs (1).
A study found a change in the cortisol response during a stress provocation test before and after four months of TM practice. In the TM group there was a considerable decrease of the cortisol levels before the test compared to before learning TM. The cortisol increased more during the test and afterwards it returned rapidly to the low pre-test level. A control group that had learnt a stress coping program had unchanged cortisol levels before and during the test at the measurement after 4 months (MACLEAN CRK et al 1992).
This indicates that TM develops a more optimal way of responding to demanding situations.
Another indicator of chronically increased levels of stress hormones is hypertension. It has been well established by several studies that TM leads to a reduction of hypertension (See for example http://hyper.ahajournals.org/cgi/content/full/26/5/820 ).
People in a chronic stress condition have a high level of stress hormones and their response to demanding situations has been found to be slower and not as pronounced as in people with a low stress level. That is, their ability to mobilize their reserve resources is lower when they really are required. A lower level of stress hormones means a low load on the stress hormone producing glands. This makes it possible to mobilize higher levels of stress hormones when required.
Lower anxiety proneness - the key to stress tolerance
An important contributory factor to the stress reducing effect of TM is a reduction of primary psychological stress enhancing factors. Especially emotional insecurity (low so-called emotional basic trust) and the associated weak self-confidence causes a propensity to interpret (often subconsciously) even quite ordinary everyday situations as threatening and thereby stressful. These factors are closely related to a general anxiety-proneness (trait anxiety). This is far more prevalent than formerly believed, as it has been found that many people may be anxiety-prone and insecure without being aware of it at all, especially when they have strong psychological defense mechanisms.
So the key to increasing "stress tolerance" is to reduce trait anxiety and to increase the inner security feeling. Extensive experience shows that traditional methods for relaxation and anxiety reduction have little effect. The reason is that emotional insecurity is deeply engrained in the perosnality.
Different studies as well as clinical psychological experiences indicate that TM heals the profound personality disturbances that cause emotional insecurity and weak self confidence. Some studies have demonstrated that TM causes a greater lowering of trait anxiety than other methods (Eppley, K.R. et al, 1989; ALEXANDER CN et al 1991). Especially remarkable are the studies of the Swedish Air force, indicating that one year of TM causes an improvement of deep anxiety-related disturbances that usually take 20-30 years of psychotherapy to improve (Suurkula J, 2001)
The reduction of trait anxiety through TM causes a "positive circle" where the associated increased feeling of inner security leads to reduced cortisol which in turn reinforces the reduction of anxiety. This can be summarized in the following diagram:
Scientific research indicates that the Transcendental Meditation Program acts through different synergistic mechanisms that both reduce the stress hormone level and reduce the "stress sensitivity" (footnote 2) at a fundamental level.
The DMT study indicates that TM heals deeply engrained causes of stress sensitivity. This explains why it is experienced that its effects are permanent and increase with increasing practice. In this respect TM differs from relaxation techniques and various stress reduction methods that are designed to modify the symptoms stress rather than to address its causes (29).
Stress is a great societal problem today as it is believed to be an important contributory factor or in some cases even a major cause of our most serious and common diseases, including Cancer, Cardiovascular diseases and adult-onset diabetes (also called type 2 diabetes). It is reasonable to assume that a cumulative decrease of the stress level is a major factor accounting for the cumulative decrease of disease incidence in elderly people who practice TM, see "Seniors' Medical Costs Cut by 70 Percent with Transcendental Meditaion".
Also Stress increases, probably importantly, the tendency for all kinds of drug abuse. Therefore, being an effective stress reduction method with uniquely profound effects, it is not surprising that several studies report that TM effectively leads to reduced drug abuse (for a review see Alexander et al 1994).
Considering that stress is a major cause of dysfunction and illness in the population, it is fair to predict that generalized practice of Transcendental Meditation would have a powerful positive impact on societal expenditures caused by disease, drug abuse and related problems.
NOTE: These conclusions are based on TM research. There are considerable differences between the Transcendental Meditation Program and meditation techniques as well as various relaxation and stress reduction programs. Therefore there is no scientific basis for believing that the effects of TM are applicable on other techniques. For more about differences, see "Are all forms of meditation and relaxation the same?"
1. The stress response is not only elicited as a response to psychological threats. It also occurs when the physiology is exposed to damaging conditions or disturbances that threaten to throw it out of balance. Thus the stress response occurs at e.g. physical exertion, physical trauma, extreme heat or cold and when the body is diseased.
2. The notion "Stress sensitivity" is actually not adequate from a scientific viewpoint and may seem confusing. This is a concession to the everyday use of the term "stress" for denominating a stressprovoking situation. By "Stress sensitivity" we mean the propensity to mobilize the stress response in different situations.
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