Why is Emotion Regulation Important For My Physical Health?

I’m going to be the first to admit that when I was younger I often struggled with my emotion regulation. This often came to the forefront in the context of relationships, because I had a “short temper.” I would get angry and yell, pretty quickly. I could always calm down, but I came to realize the older I got that I had to remove myself from the situation in order to get myself to be more calm. I had a really bad breakup geez, almost 5 years ago now, that I also had a difficult time controlling my emotions, especially sadness and rumination. That last time, that was the lesson for me. But we’ll get to that in moment…

A transition from a poor emotion regulation period to a better one.

First, let’s talk about what emotion regulation is, because I know that some of you may never have really heard the term before. Emotion regulation is our attempts to control the experience, expression, time and scale of our emotions. It has been long known to be important for our mental health, and only more recently explored for physical health. These are also skills that many of us learn as children, but often do require practice throughout our lifetimes. I worked in retail for a long time and as I reflect back I can see how customers yelling at me, for let’s be honest, very small things (I had a lady yell at me once because a competitor had an item for a dollar less but she didn’t tell me before she paid – I happily would have matched it… and by yelled I mean screamed bloody murder) and I realize they were exhibiting very poor emotion regulation, which is more harmful for themselves than the stress it caused me.

If you’re yelling at retail workers (or servers, etc) you might want to check on your emotion regulation skills.

Here’s what we know about emotion regulation and physical health:

1. better emotion regulation impacts our overall physical health positively
2. difficulties with emotion regulation, especially with prolonged negative emotion, can make you more at risk at developing heart disease
3. emotional suppression and rumination (part of poor emotion regulation) cause lower energy, greater physical pain, greater disability, and overall lower quality of health
4. difficulties with emotion regulation make it difficult to engage in self-care and health-related behaviours necessary for managing chronic illness
5. better emotion regulation makes it easier to manage stressors in our lives, meaning less flares and relapses of illness
6. better emotion regulation increases medication adherence and sticking with diet and exercise regimes

Back to my story. So, I had this breakup and this very poor emotion regulation following it, and then I had a flare so terrible I ended up in the hospital for pain. I was released the same day, and the pain came down a bit, but it really went back to normal levels when I was able to come out of the depressive funk I was in. I can safely say I have not had a problem regulating my emotions since… and I mean really who wants a flare like that again? So, we’ve answered the question why, and there are lots of “how tos” in regulating emotions, but I’m going to leave you with one to try out.

A much more emotionally regulated period

Learning to self-soothe. Again, many of us learn this skill as children, but not everyone does, and often we do less of it as we get older. Some ideas for practicing self-soothing are to do meditations such as loving kindness (click here) or a relaxation practice like progressive muscle relaxation (click here). Expressive writing about the experience (click here), breathing exercises (click here), and self-care strategies like taking a bubble bath, are more ways to lear to self-soothe. There are many other strategies online so I suggest a Google search if you’re looking for more!

Take care, and keep making the most of it!
–Kelsey

Treating Depression

Depression is one of the most common mental health problems (right up there with anxiety). It also commonly co-occurs with chronic illnesses. If you’re feeling depressed, or have been diagnosed with Major Depressive Disorder, it’s really important you are treating it in some form. As a therapist-in-training, I see many clients with depression – some with both depression and anxiety, some with perinatal depression, some with depression and chronic illness – and there are a lot of evidence-based treatments out there. It’s really important to know that you don’t have to suffer alone. So I thought this week, we’d talk about some common treatments, and some up-and-coming ones for depression. I also have an entire podcast episode dedicated to depression and chronic illness this week, which you can access here.

This week’s podcast.

For chronic illness, depression most frequently occurs in people with Alzheimer’s, autoimmune diseases of all sorts, cancer, coronary heart disease, diabetes, epilepsy, HIV/AIDS, hypothyroidism, and Parkinson’s. I got into the criteria for major depressive disorder in the podcast episode, so definitely check that out for more information. When it comes to treating depression, the two most common routes are anti-depressant medications and psychotherapy. Anti-depressants most commonly come in the form of SSRIs (selective serotonin reuptake inhibitors) that alter our brain chemistry because it is implicated in depression (our brains are not the only thing that is implicated though). There is a lot of research that supports anti-depressants in treating depression, though research also shows that it works as well as a placebo. In other words, if you believe it will help it will. Now don’t get me wrong, I fully support someone taking medication (unless you’re pregnant or breast-feeding and can’t – thus why I see many perinatal moms in my practice), however what a lot of people find is that just taking medication isn’t enough to see significant improvements in their symptoms, and many people don’t want to rely on medication forever.

Depression affects about 20% of the population in their lifetime.

That’s where option 2 comes in: psychotherapy. As a student, I see about 10 clients a week plus I co-facilitate a group for 2 hours a week. There is a lot of research that supports the use of psychotherapy. My podcast episode on anxiety, which you can access here, breaks down how much your therapist and you each contribute to your outcomes in therapy, which is important to know. As for what type of therapy, there are many to choose from and they all have good outcomes. CBT (cognitive-behavioural therapy) and it’s third-wave counterparts (DBT, ACT, SFT, etc) are the most common. Typically this involves a combination of talk therapy, where you tell your therapist about your thoughts and feelings, and then the therapist giving you some things to try out in session that you can also practice between sessions (some people call it “homework” but I don’t like that term). Another option for therapy is psychodynamic, which involves talk therapy plus the therapist often makes interpretations. And then there are the therapies that rely mostly on talk, utilizing the therapeutic relationship, such as person-centred, existential, etc. All of these can help and are something I highly recommend. There is also evidence that different lengths of therapy are beneficial as well, from one session of drop-in counselling to short-term (10-20 sessions) of CBT or long-term (more than 20 sessions) of person-centred therapy.

Our thoughts and feelings can be like quicksand. Our natural tendency is to struggle, but that only makes us sink deeper in. The actual way to get out of real quick sand: be a still and flat as possible and let yourself float to the surface.

If you are in immediate crisis because of self-harm, abuse, trauma, and suicidal thoughts/plans, then please contact your local help line. I’ve put some numbers in the show notes for my podcast on depression. A quick Google search can help you find them in your country. If you don’t like talking on the phone, there are some organization that offer texting services. I volunteered for Kids Help Phone in Canada which had switched to primarily a texting hotline since many young people prefer to text. You are strong for reaching out because it is not easy to.

Canada.

In terms of other treatments, a few are available for treatment-resistant and severe depression. Electroconvulsive therapy (ECT), which used to be called “shock therapy” can be helpful for people with severe depression, though there are some potential harmful side effects, and psychiatrists don’t commonly use this unless necessary. Transcranial Magnetic Stimulation (TMS) is another option for treatment-resistant depression where magnetic pulses stimulate the nerves in your brain. Newly approved in Canada (and how I got the idea for this post) is the use of Ketamine for treatment-resistant depression. Ketamine is a dissociative drug that has a lot of research supporting its use for depression. It activates your glutamate, dopamine and serotonin receptors in your brain. It takes effect much quicker than anti-depressants and has shown to decrease suicidal ideation. So far research shows no long-term side-effects, though because it is a psychedelic drug, there is the chance of substance dependency.

Great video for anxiety and depression.

Whether or not you have chronic illness, if you have depression there is hope for recovery, and lots of options available. Talk to your GP, your psychiatrist, a psychotherapist or whomever else is or could be part of your mental health care team. That way, you can keep making the most of it.

Optimism, Pessimism, Mental Health & Chronic Illness

“Positivity is not about how to maintain a positive attitude, but how to produce positive emotions.” – Frederickson, 2009.

“Research indicates that pessimism correlates with depression, lowered achievement, and health problems.” – Martin Seligman, 1998.

If you don’t know who Seligman is, that’s totally okay and to be honest totally normal if you haven’t studied psychology. He’s the founder of positive psychology (which does not say that positivity is the cure to mental health, just to be clear) and has done a lot of research in this area. For me, the interesting part of the statement isn’t the mental health aspects, which are a bit less surprising, but the physical health part, because what does that mean for people with a chronic illness?

Are you an optimist or a pessimist?

Okay, so here’s a quick overview of some research of optimism vs. pessimism and chronic pain or illness. According to Forgeard and Seligman (2012) disease may progress slower for optimists than for pessimists. Optimists typically have better cardiovascular (heart) functioning and less heart disease, and they may have better immune functioning (though the research is more mixed on that the later). They also found that cancer patients had better survival rates one year after diagnosis if they were optimists, and that in general optimists are about half as likely to die from whatever disease they have than pessimists are. They do caution that some studies don’t show this effect and/or the results are negative, but it’s theorized that the stage of disease may play into this. They also theorize that unrealistic vs. realistic optimism plays a role. (I’ve often said that you can be – and that I am – a realistic optimist).

Life of a realistic optimist.

In terms of chronic pain, Ramirez-Maestre et al. (2012) found that optimism leads to better overall well-being and this might have to do with coping strategies that optimists and pessimists use. Basically, pessimists are more likely to use passive coping strategies such as avoidance and optimists are more likely to use active coping strategies such as acceptance. Active coping leads to lower pain severity, less depression, and better daily functioning.

I don’t know about you, but less pain always sounds good to me!

I can hear some of you saying, “But I’m naturally pessimistic! I can’t help it!” Positive psychology actually shows that we can have learned helplessness and learned optimism – yes, I said it, we can learn optimism. It’s not necessarily a fixed part of personality and there is research to support that. Basically, if we learn to combat negative self-talk, we can become more positive. Pessimism is caused by selecting our attention to certain things as well as a lack of internal confidence in our abilities to control or change parts of our lives (learned helplessness) so when we fail at something, we blame it on something within us we can’t change. I hope I didn’t lose anyone during this.

Seligman explains this way better than I do.

If you want to be more optimistic here’s something things you can do, according to Seligman:

• utilize gratitude (maybe use a gratitude journal or write a gratitude letter)
• help others in need (by volunteering for example)
• challenge your negative thoughts and believes (what’s the evidence for and against them)
• tackle your negative self-talk (trying changing it)

In the Science of Well-Being course taught by Yale professor Laurie Santos, she explains that only 50% of our happiness comes from genes. So, if you’re still believing that you can’t change from being a pessimistic to an optimistic because it’s how you are born, then remember that. 10% of our happiness comes from our circumstances, and the last 40% comes from our actions and thoughts. Which means, you can still improve your levels of happiness (and thereby some aspects of your health) even if you’re not naturally inclined to optimism.

If you haven’t checked out The Science of Well-Being course yet (it’s free), then I highly recommend it!

I hope this was helpful for some of you! Let me know how it goes with those four techniques to learning optimism! Keep on making the most of it!