Ways to Improve Your Stress Response: and the correlations to chronic illness

I was listening to a podcast a few weeks ago and the guest was talking about the physiology of our fight-flight-freeze response and how it can specifically relate to certain chronic illness. The guest used the following examples: lupus as being the fight response, and CFS/ME as being the freeze response. I had never thought of it this way and it made me interested in this topic. (The podcast is called Therapy Chat if anyone is interested but I can’t remember the specific episode number, sorry!). Fight-flight-freeze is also known as the stress response, which is a product of evolution that kept our species alive for a long time, however, if you ask many people with chronic illnesses (especially autoimmune diseases) you’ll have a lot of people tell you about chronic stress, trauma history, and attachment issues, all of which can dysregulate our stress response. Usually this occurs in childhood, and I can specifically remember 5 years where I had chronic stress (at school only, due to a traumatic friendship).

I’m going to try to explain the stress response in the easiest, most non-technical way possible (because honestly my eyes glaze over when I have to read about brain anatomy, and I’m guessing I’m not alone in that). So there are a few different parts of our autonomic nervous system, most notably the sympathetic nervous system (fight and flight) and our parasympathetic nervous system (freeze). There is also our vagus nerve which is really important in understanding the nervous system but I’ll leave polyvagal theory for another time. Sympathetic activates us to either fight or run away in order to survive, whereas the parasympathetic suppresses everything in order to keep our bodies alive when we can’t fight or flight. The problem is that when our stress response is chronically activated, it can impair our physical and mental health. I want to put a caveat here for the rest of this post, correlation does not mean causation, however, most theories do point to chronic stress as being causation (at least partially – biopsychosocial approach) for a lot of illnesses.

Image from: https://www.youtube.com/watch?v=DPWEhl7gbu4

I think it’s also important to talk about stress-related disorders, because they tend to also be diagnosed in people with autoimmune diseases. Examples include acute stress disorders (same symptoms as PTSD but only lasting between 3-30 days), posttraumatic stress disorder (which most people seem to have a basic understanding of), and adjustment disorders (occurs during major life changes). Attachment disorders can also contribute. One study I looked at found that people with a stress-related disorder were more likely to not only develop an autoimmune disease, but to actually be diagnosed with multiple ones, and had a higher rate of them if they were younger when having the stress-related disorder.

Let’s talk about chronic stress – when our stress response is activated for a long period of time (i.e., daily stress as opposed to one major stressor) – because a lot of research has been done in this area. Here is a bunch of things that chronic stress can do:

  • contribute to high blood pressure
  • contribute to anxiety, depression, OCD, anorexia nervosa, and substance use disorder (and withdrawal)
  • contribute to obesity (increase appetite, leading to weight gain)
  • suppress or dysregulate immune function (leading to inflammatory disorders and hyperactive immune systems such as in RA and lupus)
  • suppress the reproductive system
  • suppress growth in children (lots of studies of children in orphanages)
  • digestive problems
  • switch off disease-fighting white blood cells, increasing risk of cancer
  • worsen symptoms in lupus patients
  • contributes to malnutrition
  • contributes to poorly controlled diabetes
  • contributes to hyperthyroidism
Stress always worsens my UCTD symptoms.

So that’s a lot. I mentioned ME/CFS as the beginning of this post as well, which is associated with the physiological state of freeze, as examined by metabolic changes. Some research indicated that people with ME/CFS are “wired,” meaning a combination of both the fight/flight and freeze responses, leading them to feel wired and tired at once. I hope this gives you some understanding of what is going on with you if you have any of the illnesses mentioned in this post. Understanding is one thing, but what can we do to help ourselves, especially if we are in a chronic stress response? While there is no right answer, there are definitely things we can try (and a bunch have worked for me!)

  • Deep breathing (into the diaphragm) – for many people this lowers stress (it sometimes increases anxiety for me, so I personally find it more effective to do mindful breathing)
  • visualizations and guided imagery – try this one out.
  • Prayer – this is a mindful activity that many people find helpful
  • Yoga and Tai Chi – mindful movement can be very grounding – listen to this podcast episode about it.
  • Walking (and other forms of exercise) – for many people this lowers the stress response, for some people it can increase it due to heart rate increases
  • Journaling – you have to like to write/journal for this one but it can be helpful to get your thoughts out of your head
  • Biofeedback – this is a technique in which you can learn to control some of your bodily functions (i.e., heart rate)
  • Progressive Muscle Relaxation – try this one out.
  • Massage – I personally find massages to be both relaxing and therapeutic
  • Acupuncture – there is research showing it helps with both stress and chronic pain
  • Social Support – from friends, family, colleagues, support groups (in person or online), and pets!
Furry friend social support.

Hopefully that gives you a few ideas for how to lower your stress response. Keep making the most of it!

The Body-Mind Connection

There is such a delicate balance between the body and mind and how they interact with each other. At the core, our mind… or more specifically our brain, controls everything from our thoughts and feelings to our pain levels to basic functions such as breathing. It sends the signals to all the body parts. Our bodies can also let our brains know when we’ve been injured for example. But what happens when there is too strong an influence of one over the other? This often happens in chronic pain, when the pain signals are amplified much more than they should be. Another common problem is the influence of our mental health on our chronic pain. For example, if you have higher anxiety or depression, you might notice that you have higher chronic pain as well. This is part of why I’m specializing in chronic illness as a psychotherapist. The balance is delicate and all parts of health need to be looked after in order for us all to live our best lives.

Let’s look at fibromyalgia as an example, because it is a fairly common chronic pain condition. According to medical research, depression and pain share receptors in the brain. So it’s common for people with fibromyalgia to develop depression (less common the other way around but still possible).Dr. Ananya Mandel (news-medical.net) So treating depression and chronic pain at the same time can be beneficial. A number of antidepressants have found to be in treating both. If you think you’re already on a lot of medication and don’t want to take anymore, then therapy for depression, may also impact chronic pain, especially if you’re clear with the therapist that you’re looking to treat both simultaneously. An even more interesting example is anxiety, which often feeds chronic pain, making it feel worse. Anxiety can increase how sensitive we are to pain, and therefore make the pain worse than it would be without anxiety. Dr. Ananya Mandel (news-medical.net) That being said, having pain can lead to anxiety, and so it is a vicious cycle. In this case, it might be more beneficial to treat the anxiety rather than the pain. As anxiety decreases, pain should decrease as well. Whether it’s pharmacological interventions, or psychotherapeutic ones (though for anxiety best results are always a combination of the two), if you have a lot of anxiety and a lot of chronic pain, it might be time to get a referral to a mental health professional!

I have a diagnosis of fibromyalgia (along with UCTD) and I used to have anxiety. While I do still have chronic pain, it is much less intense than when my anxiety was bad.

Let’s quickly talk about stigma, because while it’s decreasing, I want to recognize that some people still struggle with it. You are not crazy if you seek out mental health help. You’re not abnormal. A lot of things people tell me are normal, or do make sense given their circumstances. Mental health help is not just for the severely ill, it’s for everyone, because everyone struggles. If it’s a family member that is playing into the stigmatization for you, get them to read this post, or heck the millions of other posts and articles out there on mental health and stigma, and who is seeking services for what. And if that doesn’t help, remember that you have to do what’s best for you, not for other people.

If you have more questions about the body-mind connection, I am going to be doing a podcast episode on it in the near future, so feel free to email or DM me (on Instagram) some questions and I’ll answer them on air! Until then, keep making the most of it!

Chronically Living and how to make the most of it – new episodes every Monday!

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Dealing with Brain Fog

So, I will admit that I don’t get brain fog too often. Maybe like once a month, usually at night, and it’s usually not too bad. It is one of the reasons that when I was working my rheumatologist gave me a note saying that I couldn’t work after 7pm (no one ever followed that rule exactly though, it would be 7:30 or 8 usually). However, on Monday I had serious brain fog.

The whole day felt off. I did yoga in the morning, then did school work, okay seemed fine. Went to a chiropractor appointment at noon. Still okay. Got home started to feel beyond exhausted. Checked the times for my discussion group for school – 7:30. Okay. Felt more tired (apparently I ran out of spoons really fast that day). Took a nap (I never take naps because they make me feel groggy) because I literally couldn’t stay awake. Got up half an hour later. Felt slightly better. Checked the times again for the discussion group – still read 7:30. Chill out for a bit, take a bath. Check the times again. Still read 7:30. Then 7:30 rolls around so I log in (after again just reading the 7:30 start time) and no one is there… Check the times again. It says 7:30 Atlantic time, 6:30 Eastern. Then I had a major anxiety attack and eventually got myself in the other group that night (discussion started at 9). I did feel a bit better later but geez was that whole day weird.

So what did I do between 7:30 and 9:00 other than freak out and join the other group? I did something that I wasn’t even sure was going to help but did a bit (not a lot but enough that I could actually participate in the discussion group). I played the piano. Music is great for the brain. In fact there are studies that suggest that learning to play an instrument can delay or reduce your risk of dementia. I purposefully picked songs that I knew how to play, are slightly complicated, and hadn’t really played for a long time. I forced my brain to work. Did I play them perfectly? No. I did play them well enough though.

Technically I only have a keyboard at my current place. My actual piano resides at my parents’.

To be honest, I’ve tried a few Google searches and there aren’t a lot of “remedies” for brain fog. Usually it’s just something Spoonies have to deal with, so either the day is a write off or you just sleep more or veg. I did find one article (https://www.healthline.com/health/brain-fog#treatment) that offers a few ideas that I think I’ll try to keep in mind (though I’m pretty sure piano will be my go to). Making sure you are getting enough sleep at night (8 hours), manage your stress (meditations or yoga anyone?), not drinking too much alcohol or caffeine, doing exercises for your brain (puzzles, word games, piano), and proper nutrition (protein, fats, vegetables and fruits!). Okay so none of these are a cure but I’d be willing to try any and all if it means that the brain fog is even less bad in the future. In fact, probably doing a lot of this on a regular basis would help prevent brain fog (and as I mentioned I don’t get it often).

Disc golf counts as exercise right?

What are your thoughts on brain fog? Anything that works to help you? Comment or DM me on Instagram @janeversuspain.