For the past two years, Matthew Katz has been using a mindfulness technique to deal with chronic migraine. Called mindfulness of emotions, it teaches him to check in with his mind and body a few minutes each day and take inventory of how he's feeling.
He also practices mindfulness through meditation, yoga, and journaling, rituals that have helped curtail his pain significantly. Since the COVID-19 outbreak, he's come to appreciate these practices even more. "The pandemic represents a collective uncertainty," says Katz, a lawyer and father of two in Indianapolis. "And mindfulness allows me to sit with that uncertainty."

To deal with the crisis, he has increased the number of times he does formal meditation, and he devotes more hours to journaling. "It's been a difficult couple of months, but I feel equipped to approach it with less panic."

Rooted in Buddhist philosophy, mindfulness was introduced as a stress reduction technique in 1979 by Jon Kabat-Zinn, PhD, who defined it as "awareness that arises through paying attention, on purpose, to the present moment, nonjudgmentally." It can be practiced by meditating, doing yoga, or while engaging in activities such as walking, cooking, or brushing your teeth, according to Dr. Kabat-Zinn.

Being aware of bodily sensations, as well as thoughts and emotional processes coursing through your mind from moment to moment, allows you to respond to daily stressors in a healthy way, rather than simply reacting to them, says David Vago, PhD, a cognitive neuroscientist at the Osher Center for Integrative Medicine at Vanderbilt University Medical Center in Nashville. "Mindfulness can teach you to absorb what's happening, pause, and then respond in a more adaptive way."

If you're overwhelmed by anxiety, perhaps related to the COVID-19 situation, take a moment to center yourself by becoming aware of your breath. You may be able to focus better on the task at hand or respond in a more balanced way to people demanding your attention. "Just stopping and taking inventory of your thoughts and actions creates a buffer between an external stimulus and your response to it," Dr. Vago says.

Decades of research show that mindfulness practices can improve sleep quality, lower blood pressure, and reduce overall stress. A small study published in the Journal of Human Hypertension in 2019 showed that eight weeks of mindfulness meditation reduced blood pressure in patients with mild hypertension.

As it did for Katz, mindfulness can be used to manage chronic pain. In a pilot study, published in the September 2019 issue of Headache, participants kept a daily headache journal and either underwent eight weeks of individual mindfulness-based cognitive therapy (MBCT) sessions or had their usual treatment. Those who participated in MBCT sessions reported lower levels of daily disability at the end of the eight weeks, although their pain levels stayed the same.

A mindfulness approach teaches patients to turn toward the source of their pain and pay attention, rather than medicating it away, says Rebecca E. Wells, MD, MPH, a headache specialist at Wake Forest Baptist Health in Winston-Salem, NC. If you can focus on the headache, instead of the anxieties and thoughts that come with it, you can cope with it more successfully, says Dr. Wells, the co-author of a 2014 study in Headache on mindfulness and chronic pain.

Although mindfulness has numerous benefits, it's not a one-size-fits-all approach, cautions Dr. Wells. "There's no prescription for the amount of mindfulness you have to do to see a difference," she says. "It's a way of changing how you relate to yourself and to your pain." Begin practicing mindfulness by listening purposefully to music, focusing on a hobby, or walking in nature. When out in nature, observe the color of the leaves, feel the sensation of the air on your skin, and listen to the sounds of the birds. If thoughts distract you from the present experience, bring your mind back to it.

In addition to mindfulness, researchers are applying behavioral therapies to various conditions and in various ways, including through smartphone apps. RELAXaHEAD, an app created by Mia Minen, MD, MPH, a headache specialist at NYU Langone Health, guides users through a series of progressive muscle relaxation exercises. In a study published in Nature Digital Medicine in June 2019, Dr. Minen and colleagues found that the app, which is not commercially available yet, reduced the frequency of migraines and improved users' quality of life.

Katz, inspired by his own experience, created an app called ZenPops, which sends periodic messages to users' phones or smartwatches reminding them to take a moment and be mindful. "It has helped me to check in with myself and see if there's anything I need."

No matter how it's practiced, mindfulness is even more important now, says Heidi Beck Schwarz, MD, FAAN, professor of neurology at the University of Rochester Medical Center in New York, who teaches mindfulness to third-year medical students. "Mindfulness shows us that we can only control who we are and what we do at this moment—and that's enough."

How to Be Mindful

In order to practice mindfulness, you must STOP.

STOP what you're doing. "We're so used to reacting quickly to situations, rather than stopping, absorbing everything, and responding in a healthier way," says David Vago, PhD, a cognitive neuroscientist at the Osher Center for Integrative Medicine at Vanderbilt University Medical Center in Nashville.

TAKE a few deep breaths to bring yourself into the present moment.

OBSERVE what is happening in your body and with your emotions. Do you feel a tightness in your chest or tension in your shoulders? Are your thoughts racing from one to the next? Are you preoccupied with tasks you need to accomplish later in the day? "Here is where you can reflect on your own mental processing," says Dr. Vago. "A powerful aspect of any mindfulness practice is to observe how your mind is working in the present moment."

PROCEED with whatever you are doing and make an intentional choice to incorporate what you've observed in order to fashion a more reasonable and objective response.

5 Mindfulness Apps

• Headspace (headspace.com): Headspace is offering some meditations for free during COVID-19. Otherwise, a subscription is $12.99 a month or $95 a year.
• Buddhify (buddhify.com): Its meditations are specifically tailored for certain activities, such as waking up, eating, or travel, and cost $4.99 each.
• Calm (calm.com): Calm has made free guided meditations available during the pandemic. A subscription to its full catalog is $12.99 a month or $59.99 a year.
• Insight Timer (insighttimer.com): This free app allows users to time their daily meditation sessions and track their progress.
• Glo (glo.com): This app features guided meditations to use with yoga movements, with an emphasis on breath. A subscription costs $22.99 per month.