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Mind-Body Interactions

By

Alexandra Villa-Forte

, MD, MPH, Cleveland Clinic

Last full review/revision Oct 2019| Content last modified Jan 2020
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Most people, on the basis of either intuition or personal experience, believe that emotional stress can cause or alter the course of even major physical diseases. How these stressors do this is not clear. Emotions obviously can affect certain body functions, such as heart rate, blood pressure, sweating, sleep patterns, stomach acid secretion, and bowel movements, but other relationships are less obvious. For example, the pathways and mechanisms by which the brain and immune system interact are only beginning to be identified. It is remarkable that the brain can alter the activity of white blood cells and thus an immune response because white blood cells travel through the body in blood or lymph vessels and are not attached to nerves. Nevertheless, research has shown that the brain does communicate with the white blood cells. For example, depression Depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more may suppress the immune system and make a person more susceptible to infections such as the common cold.

Stress can cause physical symptoms even though no physical disease may be present because the body responds physiologically to emotional stress. For example, stress can cause anxiety Overview of Anxiety Disorders Anxiety is a feeling of nervousness, worry, or unease that is a normal human experience. It is also present in a wide range of psychiatric disorders, including generalized anxiety disorder,... read more , which then triggers the autonomic nervous system Overview of the Autonomic Nervous System The autonomic nervous system regulates certain body processes, such as blood pressure and the rate of breathing. This system works automatically (autonomously), without a person’s conscious... read more Overview of the Autonomic Nervous System and hormones such as epinephrine to speed up the heart rate and to increase the blood pressure and the amount of sweating. Stress can also cause muscle tension, leading to pain in the neck, back, head, or elsewhere.

The mind-body interaction is a two-way street. Not only can psychologic factors contribute to the onset or aggravation of a wide variety of physical disorders, but also physical diseases can affect a person's thinking or mood. People with life-threatening, recurring, or chronic physical disorders commonly become depressed. The depression may worsen the effects of the physical disease and add to a person's misery.

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Default Surrogate Decision Making
When people are unable to make their own healthcare decisions, someone with authority to make these decisions for them is needed (a surrogate decision maker). A document called a “healthcare power of attorney” may specify such a person. Sometimes a court will appoint a guardian with this authority. But in the absence of a designated surrogate, most states will appoint a so-called default surrogate decision maker, usually the next of kin. Assuming the person is married with living adult children, siblings, and parents, which of the following people would most likely be named surrogate decision maker in most states?
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