‘We Are All Suffering from Stressors Right Now’.
Anxiety is a condition that MPH student Ashima Dogra has learned much about in recent years, from a personal and professional standpoint.
In 2018, after working at an inpatient hospital and studying for the US medical licensing exam, Dogra became bedridden for months, unable to stand or walk for more than a few minutes at a time and overcome by frequent and inexplicable panic attacks.
After months of testing, she was finally diagnosed with postural orthostatic tachycardia syndrome (POTS), an autonomic condition that affects circulation and is characterized by a host of symptoms, including rapid heartbeat, dizziness/lightheadedness, fainting, brain fog, blurred vision, body aches, and abdominal pain.
But when medications failed to relieve her symptoms, Dogra decided to return to her hometown of Nangal, India to develop a holistic approach to healing with her father, who practiced meditation and breathing exercises for 30 years. On a daily basis, she began practicing different types of pranayama, the practice of controlled breathing in yoga, including an alternate nostril breathing technique called anulom vilom, which promotes relaxation and reduces anxiety.
“Within a year, I was almost back to normal—running, walking, and thinking clearly—without any medication,” says Dogra, who continues to meditate and practice yoga. “Pranayama is one of the most important things in my daily life that helps keep my symptoms at bay. This sparked my interest in understanding how our mental health and psychological wellbeing can be influenced by our physical health, and vice versa.”
At SPH, Dogra is completing certificates in epidemiology and biostatistics, as well mental health. She received her medical degree from Tbilisi State Medical University in Georgia (Eurasia) and has worked with rural populations as a medical assistant for an OB-GYN in Punjab, India. Now licensed to practice in the US, Dogra plans to pursue a career in family medicine, placing an emphasis on preventative care, holistic interventions, and a deeper understanding of the ways in which chronic stress contributes to illnesses and other aspects of physical health.
Dogra also speaks about how daily stress can have strong somatic symptoms, and how different people have different thresholds for the stressors. In a blog post for Medium, she wrote that resilience fuels these thresholds and describes how holistic ways can improve this resilience.
At the population level, there are not enough interventions designed to address mental and behavioral health issues, Dogra says.
Anxiety was one of the most debilitating things that I experienced.
“Even during the process of my POTS diagnosis, my doctors were less interested in addressing my anxiety about the disease than they were about issues with my heart or my brain,” Dogra says. “But the anxiety was one of the most debilitating things that I experienced. Once I got rid of it, my symptoms started improving drastically over the year.”
Dogra is also studying chronic stress and its impact on physical health outcomes as an intern at the Lee Kum Sheung Center for Health and Happiness at Harvard T. H. Chan School of Public Health. She is currently co-authoring a paper about the development of an instrument that assesses well-being in the workplace, as well as a paper that explores how work conditions can lead to burnout.
Dogra says it is also important to her to help fellow students and peers identify and mitigate the chronic stress in their academic, professional, and personal lives. She is the 2020-2021 president of the student organizations Express, Heal, Triumph (EHT), which offers a comfortable space for students to share their experiences and build confidence, as well as Mental Health-Public Health Connections, which promotes awareness and education around physical and mental health, and the connections between behavioral disorders and social conditions.
“We are all suffering from a lot of stressors right now, and sometimes students try to throw them under the rug just to be able to finish an assignment,” she says. “Students should know that this is not a normal amount of stress to handle, and there are psychological interventions that can be effective in mitigating that stress.”
Taking frequent breaks from work and social media, and breathing deeply while walking outside, are a couple of ways to relieve daily tension, she says, adding that just five minutes of pranayama exercises each days can lead to positive, long-lasting effects on the mind and body.