Month: March 2022

It’s hard to care about anything when you feel exhausted, burned out, or ragged around the edges. Your once-fiery enthusiasm may seem more like charred rubble due to overwhelming family responsibilities, a job that drains you, or financial struggles. Or maybe an illness, the uncertainty and disruptions of the age we live in, or a combination of factors has left you feeling as if you have precious little to give.

“What you’re experiencing is burnout. It’s real and it can lead to depression, anxiety, relationship damage, and an inability to function at home or at work,” says Dr. Marni Chanoff, an integrative psychiatrist with Harvard-affiliated McLean Hospital.

Take heart: With time and effort, you can refill your cup, slowly adding back a bit of the energy and joie de vivre you’ve been missing. Here are three ways to start.

1. Carve out time for yourself

Taking time for yourself isn’t a luxury; it’s essential to self-care. “You need to slow down and give yourself the opportunity to rest and rejuvenate,” Dr. Chanoff says, “Schedule it if you have to, starting with 10 or 15 minutes, a couple of times a day.”

How can you reclaim precious minutes in an overly full schedule? “Look at your day, week, or month, and be discerning about how many things you say ‘yes’ to in one period of time. Give yourself permission to say ‘no thank you’ to things that deplete you or don’t serve you,” Dr. Chanoff says.

Make small moments count: choose what makes you feel at peace. For example, have a cup of tea, or simply lay a blanket or mat on the floor at home or work and lie on your back. Don’t look at your phone or email. “You want to tell your body to take a break. It helps you reset and back away when stress draws you in,” Dr. Chanoff explains.

2. Commit to better health

A strong body helps balance the stressful situations that have caused your burnout. The basic recipe for good health includes:

• Exercise. Moderate intensity exercise, the kind that works the heart and lungs, releases important chemicals that help regulate mood, sleep, and many body systems. Aim for at least 150 minutes of exercise per week, which amounts to about 22 minutes a day. Start with just a few minutes a day if it’s all you can do. It doesn’t have to be fancy. “It can be any movement that brings you joy, like dancing, yoga, or brisk walking,” Dr. Chanoff suggests.
• A good diet. Eating lots of junk food (typically full of sugar, salt, and unhealthy saturated fat) fuels chronic stress, fatigue, depression, and anxiety. Choose more unprocessed foods such as vegetables, fruits, whole grains, legumes, lean proteins (fish or poultry), and unsaturated fats (such as avocados or olive oil). If time is an issue, Chanoff suggests batch-cooking simple, healthy foods you can have several days of the week. (Lentil or bean soup is a good one-pot meal. Throw in as many vegetables as you can.)
• Sleep. Insufficient sleep affects overall health, concentration, and mood. Try to sleep seven to nine hours per night. “It helps to wind down an hour or two before you fall asleep. And practice good sleep hygiene: turn off your phone, keep your room cool and dark, and go to sleep and wake up at the same time each day,” Dr. Chanoff advises.

3. Surround yourself with comfort

Hygge (pronounced HOO-ga) is the Danish concept of cozy comfort that brings happiness and contentment. Folks in Denmark know a thing or two about finding sunshine in cold dark months.

To practice hygge, surround yourself with people, activities, and things that make you feel cozy, loved, happy, or content. Go simple: spend time with your favorite people, add a small vase of flowers to your space, don fuzzy slippers once home, eat a treasured comfort food, or listen to a favorite song.

More ideas to try:

• Light a candle.
• Get under a heated blanket.
• Frame a photo of a happy time.
• Have breakfast in bed.
• Use pretty table linens.
• Indulge in art (check out various works at museums online).
• Stand still outside to listen to the sounds of nature.
• Curl up in a cozy chair.
• Window-shop in your favorite store.
• Wear a soft sweater that feels good on your skin.
• Use a silk or satin pillowcase on your bed pillow.
• Take a warm bath.
• Get an oil diffuser with a scent that reminds you of a place you love, like the beach or a pine forest.

Turn up the effect by savoring cozy comfort. How does it feel, taste, smell, or sound? “Engaging the senses with soothing stimulation can be nourishing. It counteracts ongoing stress that the nervous system endures, and may help to elicit the relaxation response — the opposite of the fight or flight [stress] response,” Dr. Chanoff explains. Breathing deeply will help, too.

Eventually, these bits of hygge, health, and personal time will give you something you probably haven’t allowed yourself in a while, and that’s compassion. Be gentle with yourself. Pamper your soul and replenish your cup, so you can continue being there for the important people and tasks in your life.

About the Author

Heidi Godman, Executive Editor, Harvard Health Letter

Heidi Godman is the executive editor of the Harvard Health Letter. Before coming to the Health Letter, she was an award-winning television news anchor and medical reporter for 25 years. Heidi was named a journalism fellow … See Full Bio View all posts by Heidi Godman

Key safety tips as legal medical and recreational marijuana evolve.

It’s fair to say that society’s views on cannabis have been evolving. Today, adult recreational use is legal in 21 states and medical use is legal in most other states, to varying degrees. The use of cannabis doesn’t seem to be going away. Given that, here is what you need to know to make using cannabis safer.

Buy it legally

If you live in a state with legal cannabis — whether medical or recreational — go through the legal market rather than the illicit market, despite the temptation of lower prices. While many state programs are less than perfect, buying cannabis through the legal market generally offers some advantages and protections:

• The product is tracked throughout its entire cycle “from seed to sale.” It’s tested for potency and to ensure it is free of contaminants. Legally bought cannabis should be free of heavy metals, disallowed pesticides, fungus, and lead.
• Labeling is increasingly accurate and helpful, showing what is actually in the cannabis you are purchasing. Different types of cannabis have different effects. You need to be able to understand what you are and aren’t consuming.
• In states where its use is legal, it is still illegal to purchase marijuana from illicit sources.
• If a contaminated product is discovered, there can be a recall.
• Keeping transactions aboveboard helps to facilitate communication with health care providers and to lessen stigma that harms medical users.

Some things to watch out for in the legal market:

• Safety and monitoring are by no means foolproof. This will get better once there are consistent federal standards.
• Do not rely on well-intentioned dispensary employees (known as budtenders) to make medical suggestions when you are purchasing. Health care providers should be answering these questions — though many are still getting up to speed on the cannabis issue.
• Be extremely careful of dosages. Don’t be upsold into buying a product that is too strong for you.
• Not all products are safe to have around the house, such as THC-infused sodas, chocolates, or gummies that any child or pet would gladly overconsume.

Pay attention to potency

The most straightforward way to get into trouble with cannabis is by consuming too high a dosage of the main active ingredient, THC. As with any medicine or drug, it is safest to use the lowest effective dose for the shortest time permitted.

Cannabis flower is far more potent than it was back in the 1970s. People who haven’t used cannabis in the modern era may inadvertently overconsume, assuming it is the same weed that they had back in the day.

Taking too much cannabis, or using cannabis that is too strong for you, can cause a severe anxiety attack, possibly landing you in the emergency department. You do not want this! Too high a dosage can also potentially trigger other medical conditions, such as cardiac arrhythmias and syncope.

Some people develop cannabis hyperemesis syndrome — uncontrolled vomiting in response to cannabis use — which can only be treated by ceasing use. Start low, go slow, and stay low is good advice, especially if you’re new to (or newly back to) using cannabis. Be careful with all edibles, especially any you make yourself: licking batter off the spoon means you’re consuming the marijuana.

Concentrates (called wax, shatter, or crumble) feature extremely high levels of THC. They often don’t have other medicinal cannabinoids such as CBD, which can mitigate some of the unwanted effects of THC. It is much easier to overconsume with these concentrates, as the THC content ranges from 40% to 90%.

Who should not use cannabis?

As with all things in medicine (including medical cannabis), there are exceptions to all rules, but generally:

• Teens should absolutely avoid using cannabis due to concerns about the effects it can have on brain development.
• Women who are pregnant or breastfeeding should abstain from cannabis due to safety concerns about its effects on a newly developing brain.
• People with certain psychiatric conditions, such as any type of psychosis, or those with a family history of schizophrenia, should avoid using cannabis, as this can worsen their condition.

If you are having trouble controlling your cannabis use or if you find it is escalating, seek professional help.

What else to know

• Don’t smoke cannabis, which can inflame your lungs. Use an under-the-tongue tincture, an edible, a topical product, or a dry herb vaporizer.
• If you do smoke cannabis, don’t hold it in your lungs for more than a second or two; holding it in longer doesn’t give you more effect, it just irritates your lungs.
• Don’t drive for at least four hours after smoking cannabis, even if you feel you are able to drive safely sooner than that. After an edible, wait eight to 12 hours before driving.
• Communicate with all of your health care providers about your cannabis use. Open dialogue helps coordinate care and avoids drug interactions.
• Avoid using cannabis for 24 hours before your shift if you work in a safety-sensitive job. You should also abstain if are on call for your job or a sick relative, or if you are in charge of children.

About the Author

Peter Grinspoon, MD, Contributor

Dr. Peter Grinspoon is a primary care physician, educator, and cannabis specialist at Massachusetts General Hospital; an instructor at Harvard Medical School; and a certified health and wellness coach. He is the author of the forthcoming book Seeing … See Full Bio View all posts by Peter Grinspoon, MD