Equine veterinarians' own wellness often receives significantly less attention, which can lead to challenges in their personal and professional lives.
The veterinary field is making considerable strides in providing wellness care for animals. Wellness programs are increasingly common in companion animal and equine medicine. These programs have been praised for increasing the number of visits, decreasing the costs of routine care and enhancing the well-being of the animal through the provision of appropriate and timely preventive care. However, our own wellness often receives significantly less attention, which can lead to challenges in our personal and professional lives.
While we don’t often speak of our own wellness, we do talk about how to manage stress. When we attend to our wellness, managing stress becomes easier. This is a tenet of resiliency—the ability to bounce back from adversity. As veterinarians, we encourage our clients to take a preventive approach to their animals’ care. We do so because we believe it will allow the animals to lead healthier lives and be better partners. The same principles can be applied to our own wellness. When we attend to our needs and engage in activities that build our resilience, we are better able to cope with the daily stresses and strains we face.
The practice of attending to one’s own needs is often referred to as “self-care,” and it is critical to achieving and maintaining wellness. To start, we should consider what a good state of wellness is. For this, we can look to the World Health Organization’s definition of the word “health”: a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.1 From this definition come specific areas of self-care to consider: the physical, mental (emotional, psychological, spiritual) and social (including workplace) aspects of one’s health.2
Below are descriptions of considerations and activities relating to self-care and personal wellness. What works for one person won’t work for another; the best self-care plan is tailored to your individual needs.
The foundation of self-care is addressing our biological and physiological needs —mainly food, drink and sleep. Despite their importance to our survival, these are often some of the first things sacrificed when life gets busy. We skip breakfast, stay up late to finish work and forget to drink fluids throughout the day. This puts our bodies and brains in a state of distress, which can lead to difficulty regulating emotions and executive function.
The term “hangry” (a combination of the words “hunger” and “angry”) has gained popularity in the past few years, and it demonstrates well how physiological states can impact psychological ones. The first step in attending to one’s wellness is ensuring that one’s biological needs are met by getting an adequate amount of sleep, fueling the body at regular intervals with healthy food and drinking enough fluids to maintain hydration.
Our body’s most basic need is oxygen; in general, we meet this need without thinking about it. Prior to veterinary school, one of my mentors taught me to take slow, purposeful, deep breaths to help calm the horses with which we were working. Since that time, I have noticed that many veterinarians and horse people do this unconsciously. It’s something you do instinctively with animals, but we forget about it with ourselves.
We can choose to turn breathing into a conscious activity to help ourselves in times of stress. Focusing on our own breathing helps us ground ourselves in our bodies, and can help stop runaway thoughts. It can help slow a racing heartbeat and loosen the tight chest sensation that often accompanies feelings of anxiety. Using breathing techniques helps us focus our minds in the present moment and diminishes excessive worry; it can also help us release negative emotions.
Here are some simple breathing exercises that can be beneficial both on a daily basis and in times of stress. Perform these either as single breaths repeated in sets of 10 or for several minutes at a time:
• square breathing: 2-second inhale, 2-second hold, 2-second exhale, 2-second pause
• focused exhaling: 2-second inhale, 8- to 10-second exhale; this allows for optimal gas exchange and requires attention to sustain
• breathing with your tongue on the roof of your mouth, right behind your upper incisors
• belly breathing with one hand on your abdomen, focusing on the rise and fall as you inhale and exhale
The physical benefits of exercise are often those that motivate individuals to do it; weight management frequently tops the list. However, numerous studies have demonstrated that there is a significant psychological benefit to exercise, as well. For example, one study found that participants who exercised at least two or three times a week experienced less depression and anger than participants who exercised less. Further, participants who exercised regularly reported being in better health and experiencing better social integration.3
Another study found that those who exercised regularly experienced significantly lower prevalence of depression and anxiety.4
Mindfulness is a practice that involves interpreting the world without judgment— attending to thoughts, sensations and emotions without assigning a value, while keeping an open mind and heart.5 Mindfulness can be applied to many different aspects of our everyday lives, such as eating and walking. The benefit to practicing mindfulness is that it helps to lower stress, decrease worry and enhance our ability to connect with the world around us.5 It does this by helping us stay present in the moment and be aware of what is real and what is not. Both mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) have been found to be effective ways to manage stress, depression and anxiety. MBSR and MBCT courses are available in many regions and online.
An example of when mindfulness could be useful is when you get a call from the answering service with a message from a high-maintenance client. Your mind might start racing with frustration and angst about what the client wants and how demanding he or she is likely to be. Using mindfulness, you would acknowledge your emotions and your response, but not let it fuel itself further. Simply take note of your reaction and emotions, and hopefully (with a little practice) you can allow the stress to extinguish itself without fueling a further reaction.
There are many different ways to meditate, and none is necessarily any better than the others. Two meditation practices that are commonly practiced are mindfulness meditation and “metta,” or loving kindness meditation. Mindfulness meditation is a meditation practice centered on attending to the breath,5 while metta involves saying specific phrases aloud while increasing positive thoughts and emotions in one’s life.6
One key aspect of any type of meditation is that it is a practice—sitting down and expecting to meditate for 20 minutes your first session is unlikely to lead to success. It is best to start with short sessions and to be patient with yourself as you learn how to meditate. There are a number of smartphone applications that can help you start a practice, including Headspace, Omvana, Buddhify and Happify.
Having an “attitude of gratitude” can go a long way toward enhancing physical and mental well-being. Research has demonstrated that it contributes to feelings of well-being and decreases negative thoughts.7 But what is gratitude? It is an emotion or mood that is experienced when one “acknowledges receiving something of value from another.” Feelings of gratitude can be enhanced by journaling, or the simple recording of occurrences for which one is grateful. Keeping a gratitude journal has been found to increase feelings of well-being, decrease complaints related to physical health, and facilitate a more positive life outlook.7 Gratitude can also increase resilience in the face of stress.8
There is also considerable value in engaging in activities you enjoy away from your veterinary practice. Hobbies and enjoyable activities are often viewed as optional. Engaging in other activities is part of social and emotional self-care. Actively participating in hobbies helps to restore our energy reserves and bolsters our mood and sense of self. It’s important to ensure that your hobby isn’t just something else on the list of things that stress you out. Activities such as recreational sports, volunteering in your community, playing a musical instrument or reading non-veterinary material are just a few examples.
Editor’s note: In the next issue, Dr. Colleen Best will discuss how to integrate self-care into your daily routine.
1. “Preamble to the constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July, 1946 by the representatives of 61 states” (official records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April, 1948.
3. Hassmen, P., Koivula, N. and Uutela, A. (2000). “Physical exercise and psychological well-being: a population study in Finland.” Prev Med, 30 (1), 17-25.
4. Goodwin, R. D. (2003). “Association between physical activity and mental disorders among adults in the United States. ”Prev Med, 36, 698–703.
6. http://www.contemplativemind.org/ practices/tree/loving-kindness
7. Emmons, R. A., & Mishra, A. (2012). “Why gratitude enhances well-being: what we know, what we need to know.” In Sheldon, K., Kashdan, T., & Steger, M.F. (Eds.) Designing the future of positive psychology: Taking stock and moving forward. New York: Oxford University Press.
8. Fredrickson, B.L., Tugade, M.M., Waugh, C.E. and Larkin, G.R. (2003). "What good are positive emotions in crisis? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001." J Personality and Soc Psychol, 84 (2), p.365.