Julie (not her real name) is a mother of two, community volunteer and a passionate supporter of local food initiatives. She recently came to see me because she was running into roadblocks managing her fatigue. She had been working with her medical doctor and specialists, but no one could uncover the "cause" of why she was feeling so run down. Admittedly, she felt like she was caught in a cycle on fatigue, anxiety and a sense of overwhelm. She felt ashamed of her fatigue and embarrassed by her anxiety. "I am a strong, intelligent women, with few, thankfully, real stressors in my life, why am I feeling this way?"
Julie's story is not unique. Fatigue and anxiety are common complaints in my practice. For many, medication has become a common solution for managing the challenges of everyday life. While a pharmacological intervention may be required for some, the majority of patients in my practice are looking for an alternative solution. They aren't looking to block the feeling of anxiety; they are looking for tools to overcome it.
Over the last 25 years, researchers have looked endlessly at tools to reduce the anxiety of children facing impending surgery. They have used medication, enabled parents to be present when kids are anesthetized and woken up -- they have even let clowns accompany kids into the operating room. Not surprisingly, none of the interventions were particularly useful. What has proven effective at reducing pre and postoperative anxiety, was allowing kids to play handheld video games. Not only was the study successful, it showed that video games were in fact more successful at managing anxiety than the best available medications. The reason for this phenomenon is due to an effect called cognitive absorption. By focusing, intensely on something other than the impending surgery, patients avoided becoming upset or panicked.
Anxiety, like pain or cravings, works on the spotlight theory of attention -- the more we focus on the problem, the worse it gets. Anxious thoughts fuel or perpetuate the physiological process and usually push the anxiety response from a place of assistance (think exam preparation) to a state of worry. Fear is a response to something that is actually going wrong (an important adaptive mechanism) whereas anxiety is a response to something that could go wrong. Video games were useful because they distracted the brain sufficiently that it shifted the spotlight and quelled the perpetuation of worry. In essence, the brain had better things to do than focus on potential (not real) outcomes.
Research has shown that game play can help to interrupt the cycle of anxiety because it breaks the cycle of attention. Even if we feel anxious while playing the game, we become too preoccupied to imagine the worst. Jane McGonical, the pioneer game creator and author of Super Better, not only cites the use of games for anxiety, but reviews the science behind the use of visual games like Candy Crush Saga for the reduction of cravings (promoting weight loss) and the use of Tetris for its ability to decrease the incidence of PTSD following exposure to traumatic events.
What fascinates me as a clinician is the emergence of new, and dare I say, fun tools, to combat a traditionally difficult and solitary set of symptoms. While cognitive behavioural therapy and other forms of mental health interventions are important clinical considerations, so too is the potential role of games.
What drives my work as a naturopathic doctor is ultimately helping people to build strong bodies and brains. I fundamentally believe that when people are well, they can change the world. Whether it is as a fully present parent, a CEO, teacher, aunt, uncle or community leader, we all have something to contribute -- to leave behind. None of this is possible however if we are missing our health, and not just the absence of disease, but the mental and physical stamina to really fulfill our missions.
Julie recently returned to my office eager to share her success. Already quite active, our intervention included some work with her diet and vitamin D status, but most significantly, we added video games to her daily routine (20 minutes daily). She focused on games that required the use of strategy and that developed resilience. All in all, her energy improved and her anxiety waned. She is feeling like her old self again... albeit, with a slight skew towards the time she devotes daily to simply having fun.
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