First, a confession. I love music and have been obsessed with rhythm from an early age. I grew up in South Africa, where music and its ritual use are a very important part of the way of life in traditional African cultures. In my home, music was always playing from the time I woke up to the time I went to sleep. What I did not know then, was that my love for music and rhythm, would be a portal into understanding the way I see health today.
In 1984, a few years after finishing my medical training in South Africa, my wife and I emigrated to the USA and settled in New York City - we could no longer continue living under Apartheid. I completed a 3 year residency in Internal Medicine and for a number of years after that, immersed myself in the study of Chinese Medicine, Functional Medicine, Nutrition, Yoga and Meditation. When I opened my own clinic, the Eleven Eleven Wellness Center in Manhattan in 1992, I had a good understanding of the strengths and weaknesses of my Western training and of all the other systems I had been studying.
Over the years, I started seeing more and more patients coming in complaining of feeling exhausted, depressed, overwhelmed, achy, run down and older than their years. They weren't sleeping well, had no sex drive and were running on empty. I labeled this "syndrome" SPENT because that's how these patients were feeling. It is a modern day stress syndrome and has become epidemic. Western Medicine does not have any solutions for it and in fact, does not even recognize that it exists despite so many people feeling this way.
When I started thinking about why this was happening, I realized that the only time I never saw patients who had these symptoms was when I was working as a doctor 28 years ago in KwaNdebele, a rural area in South Africa. I saw diseases symptomatic of physical hardship, of poverty and malnutrition, very different to what I see today in my practice. There was no electricity, indoor heating or refrigeration in KwaNdebele. Folks went to bed when it got dark, arose with the sun and ate whatever foods were available in season. They lived in accordance with the cycles and rhythms of nature, they had to.
I thought about what I had learned in Chinese medicine, that humans are part of the natural world and governed by the universal forces of nature. Human bodies do not exist in isolation; we are creatures of our environment and are subject to the powerful dictates of cyclic rhythm. This rhythm is an integral part of the self-organizing dynamic of nature and so I looked to see if there was scientific research on what I thought was happening. Sure enough there was a field called chronobiology, the science that examines cyclical phenomena in living organisms. Your body has more than 100 Circadian rhythms. They are based roughly on nature's 24-hour cycle, influencing different aspects of your body's function, including sleep & wake cycles, body temperature, hormone levels, brain wave activity, heart rate, blood pressure and even pain threshold. These rhythms are part of every aspect of our body's inner working. Although most of us know that such rhythms exist, we fail to appreciate their power in determining our health. Even in medical circles, chronobiology, the study of physiological rhythm is consistently underrated.
We have internal body clocks set precisely to these rhythms and cycles of nature. The "master clock" is located in the suprachiasmatic nucleus (SCN), a distinct group of cells located in the hypothalamus, which uses signals like light and darkness to know when to release certain hormones and neurotransmitters, which tell us when to wake or go to sleep. Destruction of the SCN results in the complete absence of a regular sleep/wake rhythm. Light is the drummer in our physiological band or orchestra, it keeps the beat, our body clocks try to harmonize themselves with nature.
Then I looked into the field of genomics, the study of genes and I had my Aha! experience on why this was happening.
We evolved over millennia as people who lived in harmony with day and night and the seasons. These cycles and rhythms became imprinted in our genes, which are almost identical to our ancient ancestors. So in our genes we are still our ancient ancestors, but we have outpaced our biology and are living at a pace that is foreign to it. Our modern lives are out of sync with these rhythms and we land up feeling Spent.
For most of us, the only time we become aware of body rhythms and their importance is if we have jet lag. This is probably the easiest way to recognize our internal body clock. Anyone who has flown over a few time zones, for instance New York to London, knows what I am talking about. You get tired easily, feel sluggish, you have trouble concentrating or thinking clearly, your body aches, you have trouble sleeping and you may even have digestive problems. But unlike when you are Spent, after a few days your body clock adjusts to the new time zone and you feel better.
Our lifestyle today simply makes it harder to stay in tune with the rhythms of nature. While no doubt beneficial in many ways, we have created artificial environments that insulate us from the cycles of the seasons and of daylight and darkness. We use artificial light to extend our activities well into the night and even during the day, we spend most of our time under artificial lights, getting very little natural light. It becomes difficult to hear the ticking of our body's internal clock. The result is that many of us pay a price as our natural body clock gets thrown out of it's natural rhythm. Our poorly synchronized lifestyles extract a significant toll.
The good news is that when prompted correctly our genetic clocks can reset themselves. The body will move naturally towards healing if we give it a chance. When our rhythms are in sync, we have more energy, everyday tasks are easier to perform, things just seem to flow better. Athletes call this "being in the zone" or having their game on. Finding your "groove" is not just psychological, it is physiological too. By making small changes in your lifestyle, you can feel remarkably more energetic, start sleeping better and reclaim your rightful vitality.
Here are just a few tips taken from my new book, Spent: End Exhaustion and Feel Great Again that will help you to reset your body clock and rediscover your natural rhythm.
* Get some natural light during the day by going for a walk, preferably in nature.
* Keep a consistent daily schedule. Get up at the same time every day, regardless of what time you go to bed.
* Have an "electronic sundown". At around 10 pm, turn off your computer, TV and all electronic equipment.
* Darken your room completely. That means covering or turning off any of the blinking or glowing lights from the alarm clock, the cell phone charger, the DVD clock and timer, etc. Each little bit of light can stop your melatonin levels from rising, which you need to induce sleep and to reach the deep restorative sleep your body requires. If you can't darken your room, wear an eye mask.
* Eat in accordance to your body's rhythms. Since your metabolism peaks at about noon, it is better for your body to have a bigger breakfast and lunch and smaller dinner. Eat good fats and protein for breakfast because that is what your body needs for fuel during the day. Healthy smoothies are a great way to get both of these into your diet. The typical sugar and carb-laden breakfast of a bagel, muffin, toast or sugary cereal are just about the worst things you can have; so avoid those at all costs.
Frank Lipman MD, is the founder and director of the Eleven Eleven Wellness Center in NYC a center whose emphasis is on preventive health care and patient education. His personal blend of Western and Eastern Medicine combined with the many other complimentary modalities he has studied, has helped thousands of people recover their energy and zest for life. He is the author of the recent SPENT: End Exhaustion and Feel Great Again (2009) and Total Renewal; 7 key steps to Resilience, Vitality and Long-Term Health (2003).
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Great article, great idea. Allopathic medicine in its immense wonderful power of scientific empiricism has a profound flaw. It lacks soul. And thus its impotence in dealing with some of the most basic problems of our high paced lives. Well done in putting a face to this, we need help in reconnecting with our intuitive & rhythmic selves & putting the 'whole' back into health.
Finally! Someone is addressing this phenomenon. Recently, I went to my doctor complain of constant fatigue. He asked "how long have you been feeling tired?" I said, "10 years." He promptly told me that this was not normal. I thought exhaustion was just a byproduct of our fast paced lifestyles!
Another reason I love this site; finally some thoughtful, common sense advice to the problems I've been having. thanks Doc!
Thrilled to see Dr. Lipman blogging for Huffington Post and able to reach all us Spent souls. Spent is served up in bite-size pieces and gave me the step-by-step process to reclaim my own rhythm, balance and health...like many I was more than Spent, I was a shadow chasing myself. Dr. Lipman has provided mindful, tasty, and healthy recipes for living your best life. The book is friendly and easy to follow. Thanks to Dr. Lipman and his highly informed understanding of the mind-body connection, I have started living my life in a rhythm that makes sense, rather than the overdrive I have been on for years where my heart, mind and body were never in sync. A sense of calm, peace and joy has replaced the train wreck that was sure to come if I stayed on the road I was traveling...I feel so much more alive, sleep better, my skin looks great and I have more energy that I have in years. My morning smoothies and easy-to-go-to refrigerator salad bar have made this transition into better eating very simple and strait-forward. Thank you for writing this incredible book that has helped restore my body and soul.
Be well, be happy, share the love and buy this book for yourself and everyone you care about - you'll be Spent no more.
This article makes lot of sense. Thanks Dr. Lipman, looking forward to more of your wisdom.
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Thanks, Dr. Frank! Great to see your experienced voice here on the HuffPost and I'm looking forward to your continued thoughtful advice.
This makes great sense! Good article.
I've started doing the "electronic sundown" about an hour before going to bed, and then I usually just read until I'm sleepy...it works!
This makes so much sense, although I would have to be physically removed from my toast and marmite in the morning, the part about getting more natural light in nature really does make a difference to your sleep patterns and general demeanor. Getting that green fix, feasting your eyes on anything that doesn't include grey buildings, is such an uplifting tool.
Dr. Lipman's book "Spent", is a jewel. Look, as Socrates said... "know thyself", and this is certainly no easy task. Many of us have stumbled and become fairly lost along the way, in this journey we call life. By ignoring our basic needs... physical, emotional and spiritual, we become divorced from our true nature, which is to be happy and healthy. On the deepest level then, we begin living in a dys-rhythmic state, which leads to illness. The beauty of Dr. Lipman is, that he understands the fundamental wisdom of wellness. As a culture, we have strayed so far from the simple wisdoms, that when they are suggested to us, they sometimes seem far-fetched. But by exploring the natural rhythms of nature and coming to feel how we ourselves can mirror those rhythms... by realizing the body is a microcosm of a magnificent macroscosm....by understanding that who we are is the sum total of all of our "parts" - and that all those parts are inextricably woven together and interdependent... by living with awareness... by eating well, sleeping well, loving well, connecting to the larger world community... that all these things lead to BEING WELL... it is a prescription which is simple, elegant and impossible to ignore any longer. In the face of a changing healthcare system, with new policy being written, we finally have a model of wellness being proposed here, rather than a model of disease-managment. Please take notice - this is important stuff!
Sounds like a good book. I'll look it up.
Dr. Lipman is awesome. I read Spent, his book, and it's just wonderful for a Doctor to be on the side of proper nutrition and real health. Truly inspired by what he has to say and recommend!
I've done all the doctor recommends and while helpful, there are a couple supplements I take that help. Spirulina and astathanthin seem to give me a boost. I won't recommend any brands, but would suggest doing one's homework before getting any. I also recently started adding just a tsp of matcha (green tea powder, but more potent) to o.j. in the morning, in lieu of coffee, and found it gives me more sustained energy. Since we're basically talking about algae and green tea products, I feel healthier than things like sugar snacks or coffee that left you up....then drop you.
Most important subject, almost perfectly explained. When it comes to meals and meal time, however, I'm affraid it may be wrong. On this point, the statement in the post, although repeating something very often said and written, is not supported by research and sound science, is a mere speculation. My speculation leads to a very different conclusion: in the wild, nobody has a breakfast served. One has to get up and go for some food which sometimes appears only late in the day, or even in the following day. And it happens that orexins, the hypothalamic hormones we produce when hungry, make us more alert and more active, whereas ingestion of a meal leaves us sleepy. I would say that this modern habit of being the whole day in a fed state, beyond blunting chronobiological oscillations and adding up too many calories, contributes to much less physical activity. This should be investigated.
I really like the suggestion of the "electronic sundown." I usually have my TV on until lights-out. But making everything at home quiet, and dimming the lights until lights-out sounds very relaxing. Sleep . . . sleep . . . sleep . . . zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
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