 So today I'm going to be talking about the importance of floating in the time of COVID-19. And I know perhaps we're all getting sick and tired of hearing about COVID-19, but it's something that is on our minds on a regular basis, on a daily basis. And it's something that we really can't escape. And it's something that has been leaving a toll on so many individuals and so many people in today's society. And so I'd like to talk a little bit about that and about how inescapable this news is. No matter where we look for news sources, we see headlines that are terrifying. News that's so scary, because it threatens our daily lives, it has an impact on us and who we are and our health. Times that are so personally threatening that they can throw our entire mind and bodies out of balance. And to give you an idea on just one way that this has affected so many people, I wanted to just show this graph. Now what you're looking at here is a chart of the search frequency for either anxiety attack or panic attack. And this dotted blue line here corresponds to March 13th, which is when Trump first declared a national emergency. And it goes all the way to May 9th at the end. And now what you can see is that there is this massive spike in searches for anxiety attack and panic attack, which it was an increase overall of 11%, but spiked as high on March 28th as an increase in 52% over the expected average for those search terms. And so what we can see is that people are looking for help. They're looking for answers because so many people are suffering in ways that is really become a national emergency. But for today's talk, I want to go a little bit deeper. I don't want to just talk about the emotional symptoms that so many of us have been experiencing, but I want to go into the body and really talk about how stress affects us on a physiological level and what that means and how floating can play a role. So to give you an idea of what I'm going to talk about, we're first going to talk about the acute stress phase, which involves the sympathetic nervous system. And then I'm going to talk about chronic stress and how that can affect the body. I'm going to talk about flotation and its effects on the autonomic nervous system. And finally, I'm going to end talking about something called long haul COVID, which you may have heard of. So to get the presentation started, I want to talk a little bit about what acute stress means for us today. And for many of us, you know, we spend a lot of time on our phones scrolling either through the news or through Facebook. It's even come up with a name, doom scrolling, we're constantly looking at articles, looking at things that strike fear into us, things that really affect our daily living and cause us to be anxious and to be scared. And why is that? Why is it that reading about news articles that can, you know, be kind of talking about the world can become so personal and induce so much fear in us individually? And we have our evolutionary ancestors to thank for that because seeing this kind of information for us is very similar to what it would have been like for our ancestors in seeing something like a sabertooth tiger. You may remember Clara from my first talk in 2018, where I talked a lot about how stress for us today is very similar to threats of life and limb that occurred for our ancestors. Seeing a sabertooth tiger and being afraid that your life might be in danger ends up being really the same physiological response as us doom scrolling through our news feed and seeing articles that are threatening to us. And so to talk about this stress response, I want you to keep in mind that it evolved for us to respond to imminent threats and dangers around us. And so I'd like to talk a little bit about what this actually does to our brain and our bodies. So let's take a look here at the brain. So what we're looking at here is cross section of our brain around the middle. It's called a sagittal brain slice. So we're looking kind of at this middle cross section. And I want to talk about a couple of regions of the brain that are involved in a threat response or threat identification. And the first area of the brain I want to talk about briefly is the thalamus. I think the thalamus often gets short shift when talking about neuroscience because it's fairly basic. It acts as a relay for sensory information that's coming through from our sense organs and going into our brain. So what we see, it's first stop is a thalamus. What we hear, it's first stop is the thalamus. And at this kind of relay station, it identifies sensory information that can be perceived as threatening. It's kind of like our brain's first pass at understanding what in our environment could hurt us or harm us. And a lot of that sensory information goes into the thalamus and then gets relayed to other areas of the cortex, other parts of the brain, that allow us to more fully process that information. But when something is threatening, when something goes through the thalamus and is identified as a threat to our life or limb or environment, it gets passed along on another route and goes to an area of the brain known as the amygdala. Now, the amygdala is a really amazing brain region that's involved with emotional arousal, but it's most famous for its involvement in fear. When we see something that is innately fear inducing, it often really activates the amygdala. The amygdala kind of identifies that something should make us afraid, and then it communicates that signal to parts of the brain that really control the body. And one of those areas is a part of the brain known as the hypothalamus, which is beneath the thalamus. And the hypothalamus is involved in a lot of hormonal activity. It's involved in behaviors and internal responses that allow us to just function, something called homeostasis. But in this case, this fear information that's being communicated from the amygdala and to the hypothalamus is then getting communicated to areas of this final cord and brainstem that are a part of a body system known as the sympathetic nervous system. And so what exactly is the sympathetic nervous system? You may be familiar with the sympathetic nervous system from its other name, the fight-or-flight system. And the sympathetic nervous system really evolved to allow us to identify, fear, when we identify something that is threatening, that we need to either get away from or we need to fight. And so it's about preparing the body for action, for getting ready for these types of responses. But what does that actually mean on a physiological level? Let's take a look at the sympathetic nervous system. Sympathetic nervous system is really a collection of a variety of nerves, as shown in orange in this body, that go throughout the entire body and really prepare an individual for action. And they can do this by communicating with their muscles, with other nerves, or with other organs within our body to relay that information. And specifically, there are a few key aspects or key physiological responses that are upregulated in the context of acute stress when we see something that's threatening. That includes elevating the heart rate and blood pressure. And this is adaptive in terms of fight-or-flight because you want to be able to move, you want to be able to get away, get stuff done, have blood pumping through all of your veins and your muscles to provide oxygen and nutrients to allow for them to move. It also induces rapid breathing. And this is to bring in as much oxygen as possible on a short-term basis to really keep the body running smoothly. It also increases sweating. And this is interesting because if you're going to be moving a lot or getting things done, you're going to need to have cooling. And your body's going to have to cool down so that it can continue working so that it doesn't overheat. And that's what this works for. Additionally, it alters metabolism and attenuates digestion. So your entire body is going to shift focus from digesting food, which is really energy-intensive, to shutting down digestion, preventing the movement of the esophagus and your intestines, and really kind of shifting metabolism to the release of more free energy. So increasing blood glucose level to allow your muscles to have enough energy to move, and really just kind of shifting the whole metabolic profile from one that is based off of digesting, using nutrients, storing nutrients to one that is just releasing and not actually processing a lot of things that are high-energy-intensive. Additionally, and I talked about this more in 2018, the sympathetic nervous system acts to activate the immune system. And if you want more details on this, you can find my talk on YouTube from 2018 conference. Just in brief, basically, if you are facing a threat that could injure you or leave you infected, you want to have your immune system ready and waiting, pre-activated so that you'll be able to handle those types of threats if they occur. Now, looking at this collection of symptoms, we can see how they really worked well from an evolutionary standpoint if you're threatened. In the case of Clara, it allows her to get away. All of that energy, all of those changes in her metabolism, in her physiology, were really designed to help get her blood pumping to help her to move. But how does that change in modern times? When we're kind of stuck, when we see something that makes us anxious, it's usually not going to be appropriate for us to run away or to fight something. And so we have all of this pent-up energy, all of these physiological responses that no longer make any sense in modern times. And in addition to that, it also could activate another aspect of our flight response. Many of you may be familiar that the fight-or-flight response has another term that kind of goes along with it and that has to do with the way that humans and mammals really respond to stress. And that fight-or-flight response or that alternative is freezing because sometimes, especially from an evolutionary standpoint, it made a lot more sense to stay in place, to hide, and to freeze rather than to fight or to flee. And the area of the brain that allows that to happen also has to do with the amygdala. The amygdala, again, once it recognizes that there is a type of fear-inducing stimulus that requires freezing, will coordinate or communicate that signal to the periapoductal gray, which is an area of our brainstem. And then that area communicates to the muscles and leads to freezing. And again, from an evolutionary standpoint, this was really beneficial. But in modern times, too much freezing in response to stress can lead to muscle tension, body aches, cramps, and can be a major problem when we don't have an actual threatening stimulus that is needing us to respond to this way. Now, so far, I've been talking about the anxious response or the sympathetic nervous system response on the short term. How do we respond to stress when it's acute, to something that we're reading about, or something that is suddenly threatening? But what about when this stress lasts for the long term? What happens when we are constantly bombarded and barraged with signals that really are threatening to us, that activate that sympathetic nervous system response, but that just don't go away? Things might have started out okay in February, but then by April, we're starting to be constantly scared, hyperarousal of the sympathetic nervous system. And by now in September, we might be dealing with symptoms of an anxiety disorder. But what does that actually mean over that long term when it comes to physiological symptoms? Well, one thing is that it disrupts digestion and metabolism. If you're constantly dealing with these stress systems that are changing the way that you digest or metabolize nutrients in the long term, that's not really going to be all that great for your body. Additionally, the toll of hyperarousal, of hyper stress arousal for extended periods of time just leads you tired and fatigued, which can be really challenging. As we'd mentioned before, it can lead to muscle pain and body aches. And this can come from tightened muscles, from excessive freezing. It can also come from an overactive inflammatory response that's kind of leaving you in this level of chronic inflammation that might be resulting in body aches. Additionally, individuals who are experienced in chronic stress might have shallow breathing. You kind of get stuck in this idea of hyperventilation, of not taking deep breaths, because you've gotten so used to an elevated sympathetic nervous system response. And along with that comes high blood pressure and tachycardia, or high heart rate. And this happens again when you've dealt with this kind of arousal for extended periods of time. Now, when we take a look at these collections of symptoms, there is a treatment, a therapy, that actually addresses most of these. And we're at a float conference, so that's just what I'm here to talk about. Amazingly, floating really can affect these physiological aspects of extended and chronic stress. And just taking a look at some data that came out of our lab a couple of years ago, this is looking at the effects of a single session of flotation and how it affects a variety of symptoms. And what we see is that there is a decrease in fatigue. Just like we talked about with fatigue being a high symptom for chronic stress, it can be alleviated through flotation. And the same with pain and muscle tension. Floating does a great job at alleviating muscle tension and pain. Additionally, though it's not on here, last year I talked about a lot of the beneficial cardiac effects of floating, about how floating can dramatically reduce blood pressure. And also that there's a lot of positive effects when we take a look at heart rate variability metrics when it comes to floating. And then additionally, there's just so many positive aspects that really help to offset anxiety and fear. Increases in feeling refreshed, relaxation, serenity, feeling content and peaceful, overall well-being, increased energy going along with the fatigue, increased happiness and positive affect. There are so many benefits that come from floating. But this is just a list of symptoms. And the question that I want to address is how exactly is floating doing this? How is it that flotation is able to really offset the effects of chronic stress? What is the mechanism behind it? And to address this, I want to again review some of the work that I talked about last year at the 2019 float conference that had to do with heart. So last year I talked a lot about how we can measure heart rate information. So electrical information from the heart using an ECG. And we can take those signals and we can decompose them into different frequencies. Specifically for this talk, we can decompose it into high frequencies and we can decompose it into low frequencies. And we can take a look at the activity in each of those frequencies and understand which one is higher or lower. And what is so amazing about measuring these frequencies from the heart is that not only is it giving us information about heart health, it's also giving us information about the general balance of our body's nervous system. Now the low frequency information indicates the system that we've been talking about already, the sympathetic nervous system. So taking a look at the power level of low frequency information from the heart rate can give us information about how strong the sympathetic nervous system response is. But I'd like to take a brief look at the other aspect of our nervous system that is underlined by this heart information and that has to do with the high frequency information, which represents the activity of the parasympathetic nervous system. Now I mentioned the parasympathetic nervous system in passing last year and I wanted to take a bit of a deeper dive into what this system does. The parasympathetic nervous system is often referred to as the rest and digest system. And that has to do with the fact that this is kind of the counterpart to the sympathetic nervous system, but it is the body's nervous system that allows for relaxation. It allows for really taking stock of downtime, being able to rest, being able to repair, being able to digest food, and it's really important and critical to the body's relaxation response. What are some of the physiological aspects of the parasympathetic nervous system? Well, it reduces heart rate and blood pressure. It allows you to kind of calm down that way. It's involved with deep breathing, taking really deep breaths from your diaphragm, bringing in lots of oxygen, lots of air, but just being able to do it in a way that's relaxing and toned down. Additionally, it's involved with relaxing muscles. And it also promotes healthy digestive metabolism. So when you're relaxing, you have time and energy to spare for really fully digesting food, extracting what's needed from it, and then storing those nutrients in ways that are more healthy. These different types of physiological responses really represent the role the parasympathetic nervous system has in relaxation. And it's kind of an opposite role in terms of the sympathetic nervous system. And so when we look at this information from the heart and it gives us this idea of the balance between these two aspects of the nervous system, we're really taking a look at a larger system in the body known as the autonomic nervous system. The autonomic nervous system takes into account both the sympathetic and parasympathetic branches and understanding its balance or being able to identify that balance is something that really gives us an idea over body health as a whole. And what's amazing is that floating actually helps to balance the autonomic nervous system from this standpoint. Well, what exactly do I mean by that? Well, let's take a look at a little bit of data from our lab and from taking a look at cardiac information. On this side, we're looking at normalized low frequency. So this is low frequency information. We're looking at time down at the bottom, which is the amount of time in the intervention. The orange is a film condition where individuals sat in a room and watched a nature documentary. The blue is the float condition where individuals were floating. Well, they had a ECG monitor attached to them that was waterproof. And what we see is that in the domain of the low frequency range, which you remember was indicative or representative of a sympathetic nervous system activity, we really see that floating leads to a decreased in sympathetic nervous system activity during flotation. And at the opposite end, when we take a look at the high frequency, if you remember the high frequency corresponds with parasympathetic nervous system activity, we can see that there is an elevation of parasympathetic nervous activity over the course of flotation as compared to watching the film. And so this is really showing that flotation has the ability to both decrease sympathetic nervous system activity, decrease that anxious arousal, and increase parasympathetic nervous system activity, really promoting relaxation. And just to hit that home, again, we see that floating is decreasing a lot of those physiological symptoms that have to do with sympathetic nervous system activity. Elevated heart rate, rapid breathing, immune system, decreased digestion, and it's really elevating and increasing the symptoms that have to go with the parasympathetic nervous system, decreasing the heart rate, leading to deeper breaths, relaxing the muscles, promoting healthy digestion. And so this is really showing the potential of flotation to take an individual who is anxious, who is aroused in that way, who is dealing with chronic stress, who has an over activation of their sympathetic nervous system, and then put them in a flow tank, and when they come out, experience an elevated activity of the parasympathetic nervous system, increased relaxation, and, you know, promotion of a lot of the physiological responses that go into having a balanced and relaxed body. This is incredible. The idea that the float, that a flotation can actually balance the autonomic nervous system is incredibly important when it comes to the level of stress and anxiety that is so prevalent in our modern world, particularly in the context of fear about COVID-19. But I wanted to talk about one more thing that's gotten me really excited recently, and that has to do with post-COVID syndrome, also known as long-haul COVID-19. Now, for this whole talk so far, up until now, we've been talking about the anxious arousal that comes from learning about COVID, hearing about it, reading news articles, being afraid of your environment, and that sort of thing, everything external. But for this last part of the talk, I want to actually talk about people who had COVID-19, and I mean had. So what's interesting and terrifying is that a large portion of people who contract COVID-19 actually have symptoms that continue after the virus is cleared. It's become known as long-haul COVID, and it involves a variety of really distressing symptoms. And I want to talk a little bit about this study that was conducted back in July that surveyed actually 1,567 individuals who identified as experiencing post-COVID symptoms as part of long-haul COVID-19. And I want to talk about some of the symptoms that they identified with. 100% every single person who was surveyed experienced increased fatigue. 66.8% experienced muscle pain and body aches. 65.1% experienced shortness of breath. 47.6% experienced elevated levels of anxiety. 32.5% experienced heart palpitations. Does this look a little familiar to you? Fatigue, muscle pain, shortness of breath, anxiety, heart palpitations. These are all symptoms that when you look at them as a category, fall under the idea of something called dysautonomia. Dysautonomia is also known as dysfunction of the autonomic nervous system. Individuals who suffer from COVID and have symptoms that will not go away experience a level of dysfunction in the balance of their autonomic nervous system that leads to a variety of symptoms that all occur because the nervous system is not in sync. And what treatment have we been talking about today that has the potential to balance the autonomic nervous system? This is something that I'm really excited about, but it's also something that's a bit at its stages of infancy. I have a colleague at Mount Sinai in New York Research Hospital who is doing research on long-haul COVID symptoms. In fact, he's part of the only clinic in the country that specifically helps people who are suffering from these symptoms. We've been having a lot of conversations back and forth about talking about the feasibility of trying to create a proof of concept, many clinical trial that explores the effects of floating on this dysautonomia in suffers from long-haul COVID-19. So far it's mainly just an idea. I've been doing a lot of work to try and figure out how to do it logistically. Some of the challenges have to do with regulatory issues, implementation, and that sort of thing. But it's something that I feel very strongly about and think that our community is positioned in an amazing way to really serve for some good in the case of COVID-19 and long-haul COVID specifically. So just to summarize, today we talked about how anxiety activates a sympathetic nervous system and that it has an evolutionary rule of allowing us to respond to threat. But in the case when there's nowhere to go, it often leads to symptoms of acute anxiety in modern times. We talked about the prolonged stress response and how that negatively affects the mind and body. We talked about how having this activation of our sympathetic nervous system over and over and over again just tires us out and wears down so many levels of our physiology. We talked about how floating can rebalance the autonomic nervous system by promoting the parasympathetic nervous system over the sympathetic nervous system based off of our heart rate data that we were able to measure. And finally, I talked about how flotation rest might actually be a promising treatment for long-haul COVID-19 and how I'm hoping to explore that more with potential proof of concept trial in the near future. So that is all I have for you today. Thank you so much for listening. I look forward to receiving some questions and also talking in the think tank if anyone wants to chat some more.