INTRODUCTION:

“The human race has one really effective Weapon and that is Laughter” -Mark Twain

OVERVIEW:

Stress is an interesting word. Most of the people have no difficulty saying when they are under stress and attributing all problems to stress¹. Stress is an unavoidable consequence of modern living. To most people living abroad is the dream – a stress-free life and never-ending holidays. Experiencing some level of stress when we are relocating is totally normal, but the COVID-19 pandemic has created a much more worrying environment than usual. Mental health problems have got worse across all age groups in the past year.

According to the World Health Organisation, mental health is," a being of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community².

According to Goldstein, “Stress is a condition where expectations genetically programmed, established by prior learning or deduced from circumstances do not match the current or anticipated perceptions of the internal or external environment³.”

India is the most depressed country in the world followed by China and the USA. A study reported in WHO, conducted for the NCMH (National Care Of Medical Health), states that at least 6.5 per cent of the Indian population suffers from some form of the serious mental disorder³. According to WHO, In India, as per the latest reports, Delhi is one of the most stressed cities with score 6.96. Delhi has one of the highest suicide rates per 100,000 people at 12.91⁴. In India, about 20 students kill themselves everyday due to the stress related to exam according to the National Crime Records Buraeu.¹Although the reasons are myriad but failure in examination, unemployment, pressure from parents etc can lead to highest rates of suicides among people aged between 15 and 29. The psychologists suggest these things and pressure lead students to anxiety and traumatic disorders⁵.

The main reasons are, throughout the childhood, their problems were met and solved by parents and teachers. As a result many adolescents are inexperienced in coping with problems alone. Secondly, because adolescents want to feel that they are independent, they demand the right of coping with their own problems, rebuffing attempts on the part of parents and teachers to help them⁶.

SOURCES OF STRESS:

1) Interpersonal issues causing stress

2) Personality related stress

3) Environmental stress

4) Change induced stress

5) Stress caused by system issues

The sign of Job Stress vary from person to person, depending on the particular situation, how long the individual has been subjected to the stressors, and the intensity of the stress itself. In a study on IT professionals, it has found that women experienced higher levels of stress and being overworked. Women professionals appeared to be more sensitive to the total number of elements in the work environment that were changing (total amount of change) as a precursor to stress. (Gallivant, 2003)⁷.

Managing stress in a professional as well non-professional life is not easy as pie, yet adaptive techniques should be employed to palliate the pressure and retrieve control. The key to this lies within each individual, which is to experiment and find out own stress management techniques that works best for each⁸.

As the old proverb says “Laughing is the best medicine” laugh can make miracles. Today in our mechanical life, every individual is full of stress and tension both at home and workplace. We have no time to laugh.

A German psychologist, Dr. Michael Titze, did a study that showed that ‘in the 1950’s people used to laugh 18 minutes a day, but today not more than 6 minutes/day despite the huge risk in the standard of living. Be being happy we enjoy the advantages of having fruitful cordial and beneficial relationships with other people, that we may meet socially⁹.

Laughter is universally well accepted phenomenon. Laughter has a healing effect even in the darkest times, and it is a uniquely human ability that apart us from animals. But the ironical part is that we do not use this wonderful ability more frequently. A study shows that the number of times a person laughs reduces from 400 times to 17 times between a pre-school age and adulthood. But being aware of the benefits of laugher we can change this by trying to laugh more often during the day.

In patients with stress and depression, laughing therapy is a non-invasive, non-pharmacological, complementary therapy, easy to learn, can be performed without assistance, less expensive and have no side effects at all¹⁰. Laughter is a form of internal jogging. It moves your internal organs around. Laughter heals all wounds and that is one thing that everybody shares.

PHASES OF LAUGHTER:

1. Hold-on laughter: Burst out laughing when breath cannot be hold any longer.

2. Gradient laughter: Fake a smile; giggle, then laugh slowly and gradually increase in tempo and volume.

3. Hearty laughter: Spread the arms up, laugh and direct our laughter to come straight from our heart, bring the arms down and again raise them up.

CLASSIFICATION OF LAUGHTER:

· Presentation laughter: Introduce our self and laugh as we do so.

· Greeting laughter: Greet everybody the way we normally greet (e.g. shake hands) and replace words with laughter.

· Nonsense laughter: Talks with nonsense words ("gibberish") and laughs.

· Language laughter: Tongue-twisters, funny syllables and words.

· Wild laughter: growling, howling, and making sounds of animals, childhood, or funny embarrassing situations.

· Vowel laughter: Haha, hahoo, heeha, heehoo, heehahoo, others.

· Consonant laughter: Meehoo, meehee, meehaa, seehaa, seemoo, and all other combinations with different vowel and consonant sounds.

· Laughter counting: Ha, haha, hahaha... until achieving continuous laugh.

· Breathing laughter: diaphragmatic breathing and laughing.

· Body laughter: laughing while playing faces and gestures that are fun and funny, practicing bodily movements (stretching, bending, jumping tumbling, others), relaxing mouth floor, modulating laughter.

· Singing laughter: funny karaoke, play-back staging, distorted songs.

· Arts laughter: crazy dancing, choreography practice, laughter choirs.

· Computer laughter: Laughter apps, electronic mirrors, funny cameras.

· Passive laughter: by watching/listening recorded laughter.

· Elevator laughter: Stand all in a clump as if in a crowded elevator and laugh.

· Hugging laughter: Hug and laugh.

· Laughter sneeze: Sneeze and laugh. Ah, aaah, aaaaaaah, ha hahahaaaaa...

· Regal laughter: Walk like a king/queen between two rows of applauding subjects.

· Poetry laughter: Conversation with chained rhyme only.

· Zipper laughter: Two rows of people standing, squeezed as much as possible (almost ear to ear, the closer they are one to another, the better), and fake laughter, looking left and right as they do so.

· Silent laughter: Start by being completely still and silent while sitting or lying down, eyes closed, and letting any laughter come out freely after a while.

· Laugh with self: Acknowledge a mistake and laugh with ourselves pointing our index or thumb at our chest as if saying “I messed up!”

· Lion laughter: Before a mirror, open mouth wide, stick our tongue out fully, use hands as if they were paws and roar laughing like a lion.

· Crying laughter: Sad crying as you lean forward, laugh as you come back up.

HOW TO PERFORM LAUGHING THERAPY:

§ Warm up by clapping hands. Almost all laughter yoga sessions begin with warm-up exercises that involve clapping and synchronizing our movements. Begin by clapping with hands parallel to each other, which will stimulate the acupressure points on our hands and increase our energy level.

§ Continue to clap with a 1-2-3 rhythm, moving hands up and down and swinging them from side to side as we clap.

§ We can then try first chant, in rhythm with our hands. Say "hoho, ha-ha-ha", breathing from belly with deep inhales and exhalations.

§ We can continue clapping and chanting as we move around the room in a circle or from side to side. Make sure we are breathing from our diaphragm with deep inhales and exhales as we clap and chant.

♦ Perform lion laughter exercise.

Another warm up we can try is lion laughter, which is derived from the Lion Posture.

§ Stick our tongue out fully and keep our mouth open.

§ Stretch our hands out like the paws of a lion and roar, then laugh from your belly.

§ We should feel a nice stretch in our facial muscles, our tongue and our throat.

§ It will also help us to loosen up and play around.

♦ Perform deep breathing exercises with laughter.

Another key element of laughter yoga is stimulating deep breathing to help us release big belly laughs. We should practice deep breathing throughout our entire laughter yoga session to allow us to access deep laughs.

§ Activate breath in the diaphragm, which is located just below our ribs. Place both hands on the diaphragm and focus on taking full inhales and exhales through our nose, expanding and contracting our diaphragm.

· Inhale deeply for the count of four and then exhale through the nose to the count of four. As we exhale, release one to two big belly laughs. Continue to do this, deepen our breath equally on our inhales and our exhales with an even breath cycle, with laughter at the end of every exhale.

· We can also chant a mantra as we inhale and exhale, such as Forgive / Forget, Live / Let live, Release/Heal.

♦ Practice playful exercises.

Loosen up by trying playful exercises to encourage laughter and joy. The idea is to motivate ourselves to laugh for no reason other than out of joy and fun.

§ Sing a playful song that goes "Every little cell in my body is happy/ Every little cell in my body is well/ Feel so good feel so swell". As we do this, tap our head, shoulders, knees, and toes. We can also add a deep laugh after we sing each line.

§ Try the electric shock laughter exercise by pretending every surface and object we touch gives us a shock of static electricity, from touching a wall to touching a part of our body. Jump back every time we touch something, smiling and laughing as we do this.

§ Chant "Very good" and "Yay" after every exercise to cultivate playfulness and joy. We can also swing our arms in a V shape as we say these chants.

A MULTITUDE OF POSSIBLE HEALTH BENEFITS:

Laughter is a great antidote to social anxiety. It provides us with physical, psychological, and social benefits, and distracts us from negative thinking habits by adding laughter to our daily lives; our therapy becomes more efficient and effective¹¹.A good sense of humor can't cure all ailments, but data is mounting about the positive things laughter can do.

♦ SHORT TERM BENEFITS:

A good laugh has great short-term effects. When we start to laugh, it doesn't just lighten our load mentally, it actually induces physical changes in our body. Laughter can:

· Stimulate many organs.

Laughter enhances our intake of oxygen-rich air, stimulates our heart, lungs and muscles, and increases the endorphins that are released by our brain. It also decreases arterial wall stiffness.

· Activate and relieve our stress response.

A rollicking laugh fires up and then cools down our stress response, and it can increase and then decrease our heart rate and blood pressure. The result? A good, relaxed feeling.

· Relax body and Soothe tension.

Laughter can also stimulate circulation and aid muscle relaxation, both of which can help reduce some of the physical symptoms of stress. A good laugh can relieve your muscles of extra stress for up to 45 minutes because it stimulates circulation.

♦ LONG-TERM BENEFITS:

Laughter isn't just a quick pick-me-up, though. It's also good for our over the long term. Laughter may:

· Improve our immune system.

Negative thoughts manifest into chemical reactions that can affect our body by bringing more stress into our system and decreasing our immunity. By contrast, positive thoughts can actually release neuropeptides that help fight stress and potentially more-serious illnesses by releasing more anti-infection antibodies.

· Relieve pain.

Laughter may ease pain by causing the body to produce its own natural painkillers.

· Increase personal satisfaction. Laughter can also make it easier to cope with difficult situations. It also helps us connect with other people.

· Improve your mood.

Many people experience depression, sometimes due to chronic illnesses. Laughter can help lessen their stress, depression and anxiety and may make us feel happier. It can also improve our self-esteem and lighten our mood.

· Regulate cortisol level.

Our body releases cortisol when we are stressed. Because it’s known as the stress hormone, cortisol gets a bad rap, but it help to manage blood sugar levels, reduces inflammation, manages metabolism, and triggers the fight or flight response in our body at critical times. But too much cortisol and our body feels that stress. Laughing increases our oxygen intake, which stimulates body circulation and decreases our cortisol level.

♦ PSYCHOLOGICAL BENEFITS:

There are also holistic benefits to laughter yoga, which can help to improve our overall health, physically and emotionally. These include:

· Better emotional intelligence: Laughter encourages a sense of play and childlike behavior, which can help to improve our emotional intelligence and our social skills.

· A better grip on negative emotions like depression, anxiety, and stress: Through laughter, we can exert a better sense of control over negative emotions that may be bringing us down, such as depression, anxiety, and stress.

· Laugh and the world laughs with you. Find a way to laugh about our own situations and watch our stress begin to fade away. Even if it feels forced at first, practice laughing. Laughter is forced at first, but it can soon turn into spontaneous laughter.

· Share a laugh. Make it a habit to spend time with friends who make us laugh. And then return the favor by sharing funny stories or jokes with those around.

Feeling of stress and anxiety are the part of life. Some levels of stress can be good for us, as the right kind of stress encourages us towards change and growth. However, when stress and anxiety exist for an extended period of time, they can become a burden or even a health risk¹². High levels of stress are believed to affect student’s health and academic functions. If the stress is not dealt with effectively, feeling of loneliness, nervousness, sleeplessness and worrying may result. Effective coping strategies facilitate the return to a balanced state, reducing the negative effects of stress¹³.

CONCLUSION:

A day without laughter is a day wasted. Always laugh when you can. It is cheap medicine. Laughter, along with other preventive and therapeutic interventions, is a sound prescription as a wonderful way to enhance mental health. Laughter is entirely feasible and appears to be the most realistic, sustainable and generalizable laughter intervention to be applied in clinical practice.We can say that laughter therapy is effective and scientifically supported as a single or adjuvant therapy. Laughter can be effective self- care tool to cope with stress.Laughter is the most beautiful and beneficial therapy God ever granted humanity. At last, we can conclude by saying that laughter is very special gift. So, we have to be very careful that it is used appropriately and not at the expense of others. But if you want to give the best “medicine”, help others learn to laugh.

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Received on 11.11.2022 Modified on 14.03.2023

Int. J. Nur. Edu. and Research. 2023; 11(3):264-268.

DOI: 10.52711/2454-2660.2023.00060