TMC PULSE

t m c p u l s e | j u ly 2 02 0 33 Craving Touch in an Era of Social Distancing Some COVID-19 guidelines present mental and physical health challenges People who are stressed or depressed, perhaps because of lack of touch, will have problems sleep- ing, Shah said. "Every single medical disease, including heart attack, diabetes, hypertension, asthma—every single physical disease—is altered if you are more anxious, more depressed or if you have more mental health issues," he said. Long term, he added, an extended period without positive physical touch could even lead to post-traumatic stress disorder. Positive touch, positive health Skin is the largest organ in the human body. A 2018 study by scientists at the Medical College of Wisconsin in Milwaukee found that skin commu- nicates positive and negative touch stimuli to our sensory neurons. The outermost layer of our skin, called the epidermis, is made up mostly of billions of keratinocyte cells. The keratinocytes release a chemical called adenosine triphos- phate, which activates receptors on the sensory nerve to convey the sensation of touch to the brain. When we hug or feel a friendly touch on our skin, our brains release oxytocin, a neuropeptide involved in increasing positive, feel-good sensations of trust, emotional bonding and social connection, while decreasing fear and anxiety responses at the same time. For this reason, oxytocin is known as the "cuddle hormone." Our desire for physical contact starts at birth. "If a baby is born prematurely, the baby may be in the NICU, but the mother is still asked to go to the NICU a few times a day to hold the baby and put the baby on her chest, even if they're not breastfeeding," Shah explained. "We know that this P ositive human touch is an integral part of human interac- tion. Whether it's a warm embrace, a reassuring hand on the shoulder or one arm linked through another, physical contact is part of how we show concern and establish camara- derie with friends and loved ones. But as we practice social distancing to prevent the commu- nity spread of COVID-19, platonic physical touch among friends and colleagues is off limits. Hugs, high- fives, friendly pats on the back or anything that breaches the six-foot rule are now taboo. "Human beings are wired to touch and be touched. When a child is born, that is how they bond with their mother," said Asim Shah, M.D., pro- fessor and executive vice chair of the Menninger Department of Psychiatry at Baylor College of Medicine. "Our wiring system has touch everywhere, so it's difficult for us not to think about physical contact." Touch starvation When physical contact becomes limited, people can develop a condi- tion called touch starvation or touch deprivation. "When someone is [touch] starved, it's like someone who is starved for food," Shah said. "They want to eat, but they can't. Their psyche and their body want to touch someone, but they can't do it because of the fear associated with, in this case, the pandemic." Touch starvation increases stress, depression and anxiety, trig- gering a cascade of negative phys- iological effects. The body releases the hormone cortisol as a response to stress, activating the body's "flight-or-fight" response. This can increase heart rate, blood pressure, respiration and muscle tension, and can suppress the digestive system and immune system—increasing the risk of infection. B y S h a n l e y P i e r c e bonding, this human-to-human touch, is important for the growth of that child." Even as adults, touch helps reg- ulate our digestion and sleep, and even boosts our immune systems. While nothing can wholly replace the benefits of positive human touch, virtual alternatives can help alleviate the effects of touch starvation. "You can have almost the same element if you [connect] by video chat—whether it's FaceTime or Zoom or Webex," Shah said. "You may not be able to engage in physi- cal touch, but you need to be able to see each other." Video chatting, he said, is about 80 percent as effective as in-person contact. Online yoga and workout classes, singing and dancing are other activities that increase the release of oxytocin in the brain. Pets also help during stressful times. The end of handshaking? It's unclear when the COVID-19 outbreak will subside or how people will physically reconnect. But the new normal of social distancing has erased customary nonverbal gestures, such as shaking hands and social hugging. Even Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases and the country's leading COVID- 19 expert, admitted that he doesn't believe people should reintroduce the handshake. "I don't think we should ever shake hands ever again, to be honest with you," Fauci said during a Wall Street Journal podcast. "Not only would it be good to prevent coro- navirus disease, it probably would decrease instances of influenza dramatically in this country." Although Shah said the "long- term impact of touch deprivation is devastating," he remains optimistic that people will overcome the stress and anxiety of physical distancing. "Human beings are very resil- ient," he said. "We will learn the new level of intimacy. We will learn the new way of human connection—and we will learn to bring joy in differ- ent ways."

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