How To Stay Awake Without Stimulants

“How are you?”
“I’m tired”

This is a standard exchange. I hear this, overhear this, and even say this myself all the time.  In naturopathic medical school we think we are working crazily hard, and it’s true, we are - but so are my friends in law school and conventional medical school and fine arts and masters programs. As well as my friends who aren’t in school at all. Many of us are grinding it out and running ourselves down. The “afternoon slump”. The exhaustion and fatigue. The bags under our eyes. These things are the common fodder of health websites and magazines, so common that millions of dollars are made every year in providing us various solutions to help us WAKE UP. This includes stimulants such as coffee and tea, as well as people who make use of more serious stimulants such as methylphenidate or amphetamines. And as budding naturopathic doctors, we have our own herbs and natural supplements to keep us going.

         a little panax ginseng...

The problem, is that the quintessential Timmy’s coffee and a donut gives a sharp caffeine sugar jolt that lifts initially, but causes you to crash hard and reach for another external source of energy to keep yourself going. Herbs can give you a gentler boost with a lesser crash, but ultimately they are still just patch solutions that aren’t really helping you address why you are fatigued in the first place. And ultimately we probably all need to take a holiday and then a few steps back and re-evaluate our work-life balance. But for now, I have two clear suggestions that have profoundly helped me personally regulate my own energy. Whereas I used to sit down in a lecture/to watch movie/to read a book and would promptly nod off, becoming conscious of these two things have helped stay awake and alert, especially during the mid-afternoon... And therefore I am able to concentrate better, think more clearly, participate in discussion more readily, and remember more.

The first is eat regularly. Eat at least every three to four hours. You can do this if you don’t eat a lot in one sitting. Make sure you have carbohydrates and protein in the meal or snack you consume. Eat unrefined and low glycemic carbohydrates (this means whole wheat rather than white bread). Favourite snacks of mine include a wrap with nut butter, nuts/seeds and dried fruit and dark chocolate, smoothies with nut butter or protein powder, full-fat yoghurt (with toppings!), toast with avocado, apples with cinnamon and almond butter, or hard boiled eggs. Otherwise I will pack myself two, smaller servings of lunch, and eat them spaced out through the day. Keeping your blood sugar regulated may seem too simple or too obvious, but try it. Really commit. Basically I use food instead of coffee. This is not right for everyone, for sure, but for me me it makes all the difference - when I discovered this it actually transformed my life, no joke. 

The second is figure out how to sit and stand, properly. This is what inspired me to write this article. I feel like I just learned how to stand, and at 26 years old, it seems a little past due. But it is actually surprisingly subtle and challenging. I would venture to say that most people do not do it properly, and because our standing posture translates into our running and swimming and every other physical activity, this is the source of many injuries over the long term. I run (or used to run, rather) with my toes slightly rotated outward, in a duck-footed position, and this has a negative effect on the alignment of my knees, my hips, my pelvis, and my back and shoulders. It seems subtle but this lack of movement integrity decreases my ability to perform well now, and over the long term takes a toll that results in pain and wear-and-tear injuries (read: knee issues). Not only that, but in the immediate short term, and in the context of our discussion about fatigue, poor posture and a collapsed chest stops me from taking a full deep breath, prevents my lungs from exchanging oxygen to my full capacity, and this diminished supply of oxygen to my brain causes me to get sleepy. 

              bad posture, good posture

The first step is to to get rid of the slouch. Sit up and take big, deep breaths. Deep sips of air, as I heard a yoga teacher say once. Re-patterning your default posture, however, is not an easy thing to do. The position your body is used to being in, all the time, is just too easy to go back to, even if you have the conscious intention of sitting up straight. A friend of mine wears a timer in his pocket, and it vibrates every two minutes, reminding him to sit up. I don’t think this is extreme if you want to change a pattern as fundamental as how you sit. You have to remind yourself to do it ALL the time.

Sitting is just the first step, however. Standing, is where it’s at (and standing properly prepares you to sit properly). I now stand in class most of the time, and I find this really helps me focus. I pay attention better. At home, I have a standing desk (i.e. a pile of textbooks stacked on top of my dresser) so I can stand and study as well. This is a trendy thing (read all about the benefits of a standing desk here). But to make it work sustainably, you have to figure out how to stand. 

Start with your feet. My tendency is to point them out to the sides, both when I am running and when I am standing. Instead, place your feet hip width apart and point them straight in front of you. Wear comfortable, flat shoes, or bare feet (the alignment of your joints from the feet, up to your knees, up to your hips and your low back, shifts slightly when you wear any kind of heeled shoe). Lightly engage your quads. Keep your knees slightly bent. Next, imagine externally rotating your legs. This means twisting your whole leg, from the hip, to the outside. You won’t actually twist because your feet are planted, but this helps engage your lateral quad muscles appropriately to protect your knees.

Moving up into your hip, engage your glutes (your bum muscles). This will tilt your pelvis slightly back, and help you with the next step, which is to engage your core muscles. In this position, your diaphragm and pelvic floor muscles (the bowl of muscles in the bottom of your pelvis) will be parallel and opposite. Your pelvic floor muscles will also be engaged (as if you were doing kegel exercises).

The last piece is your shoulders. Try to relax them down, away from your ears. Then think about engaging the muscles in between your shoulder blades, which will result in a tucking of your whole shoulder backwards. This isn’t a huge movement. Your rib cage should still be tucked in, not jutting forward. Your chest will be open and your breathing full. 

You will probably feel pretty uncomfortable at this point. You aren’t used to this. I know it seems complicated and like a lot to think about, especially if this is your first time hearing this. And now I am going to tell you, now that you are here, to relax. Back off all those engaged muscles to about 25% effort, just enough so you are still actively standing but not working hard. Then, stand like this, all day. 

For me, this is a mindfulness exercise. I continually, throughout the day, check in with myself. How am I standing? Are my glutes engaged? Is my core engaged? The more I do this, the more I strengthen these muscles, and as a result, the more I am able to do it. I have less upper back pain from slouching, less lower back pain from excess anterior pelvic tilt, and less knee pain from my previously duck-footed walk. I am more awake throughout the day, and feel better at night. I recommend starting small - stand for a little while, and then go back to sitting. Then try standing again. Just getting your blood flowing helps you stay awake. Find someone to do it with who can watch you and help make sure you are getting your body into the right position. Standing ALL DAY at work or in class - it's definitely not for everyone. But for me, it is worth it. I think of it as a practice - not something I am perfect at, but every time I remember and readjust, it is a little success, and over time this adds up to BIG change. 

Disclaimer: Information can be empowering, but we all have unique health profiles and needs. Health-related information contained in this post is intended to be general in nature and should not be used as a substitute for a visit with a Naturopathic Doctor. The advice is intended to offer only a general basis for individuals to discuss their medical condition with their health care provider.  Always consult your licensed Naturopathic Physician, or visit the Boucher Naturopathic Medical Clinic for individual care.

References:

Two big thank yous:
Dr. Rita Patel, ND, for teaching me how to regulate my blood sugar the very first time I went to see a naturopathic doctor when I was in third year university.
Dr. Kelly Starrett, for teaching me, from a book no less, how to stand properly. My description above, though it springs from my experience and is delivered in my own words, owes huge credit to him. 
Both these two changed my life.