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!

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

Sophrosyne

This week I thought we’d examine the Greek word/philosophy of sophrosyne and how it applies to living with a chronic illness. The word was first introduced during a daily post on my favourite mindfulness app. I did some subsequent research and really felt it aligned well with many of my personal beliefs and values, as well as research I’ve read in other areas concerning both physical and mental health. So, I’m bringing this concept to all of you, because I think we can all learn from it and apply it to our lives in meaningful ways.

The Greek goddess of discretion, temperance, and moderation. Image from: https://greekerthanthegreeks.com/2015/04/the-greeks-had-word-for-it-sophrosyne.html

Let’s start with the meaning of the work. Sophrosyne was a Greek goddess of discretion, temperance, and moderation. Many people really hone in on the moderation part of this, and it’s sometimes considered “mindful moderation” when talked about currently. In Greek times, it also meant “excellence of character and soundness of mind” which is what created a “well-balanced” person. Moving forward in time, there are ties to Catholicism, in which moderation is considered the final of the cardinal virtues. Jumping ahead again, Nietzche considered moderation or self-control a virtue which could be extended to self-knowledge. It is the perfect union of self-knowledge and self-restraint, thus the moderation bit. And now, as my parents have always said “moderation rules the nation,” where they referring to sophrosyne? It would appear so.

We all have many opportunities to practice moderation. How well do you do?

Why is this important, or rather, how can it help Spoonies and Chronic Illness Warriors? Well, lots of ways actually. Moderation generally requires us to be mindful of what we’re doing. We can moderate our food intake, for example, if we pay attention to how many chips we just ate, or with drinking as in how many beers we just drank. For chronic illness, this type of mindful moderation helps with self-care (which if you’re a premium content subscriber you know has benefits for physical well-being, emotional well-being, intellectual well-being, social well-being, spiritual well-being, and even work well-being). It also can help with medication management (because we know if we took our medication/properly), with emotional regulation (how we deal with our emotions so they are effective), and can decrease stress (we’re not putting ourselves into stressful situations and can recognize when we are in them, giving us the opportunity to turn away). On top of this, the mindfulness piece has a number of benefits for mental and physical health, many of which I’ve blogged about – but you can also listen to on this podcast episode.

Engaging in mindful moderation can have many benefits to health.

So, how can we practice sophrosyne in our lives? Moderation isn’t always the easiest thing to do, especially if it’s not something we’re used to. Here are three ways:

  1. Practice regular mindfulness – this could be formal meditation, mindful eating, mindful walking, or really doing anything while being fully present in the moment.
  2. Relaxation – using techniques to help keep us calm make it easier to engage in mindful moderation. Again, formal meditation works, as does breathing and progressive muscle relaxation exercise, journaling (I like the gratitude journal personally), or going to therapy to talk about our problems.
  3. Emotional Regulation – by learning and practicing emotional regulation skills we become less likely to be impulsive, and therefore, more likely to be able to engage in moderation.

I started a meditation and mindfulness channel on YouTube that currently has meditations, relaxation exercises, and grounding techniques. I will be adding more informal practices in the coming weeks. You can check out the channel here. Like and subscribe so I can keep bringing more content to it.

New mindfulness practices added weekly.

I’m going to continue to try my best to live the ideal of sophrosyne because I can see the benefits it can have and does have on my life, including my chronic illness and my mental health. I hope it can do the same for you, as you keep making the most of it!

Daily Exercise: Walking

Walking is a great way to get some exercise in, and it can be adjusted to different fitness and ability levels. If you really want to take it up a notch, trying doing some mindful walking. It will give you the benefits of exercise and mindfulness all rolled into one. Here’s a podcast episode on exercise for you to check out, and here’s one on mindfulness. Keep making the most of it everyone!

Sleep & Relaxation: A few products to try

If you’re a regular reader of this blog, then you know that I’m always looking for new ways to improve my overall health (and that I love to share my findings with all of you)! This week I want to explore a few items that can potentially help with sleep and relaxation. Sleep is incredibly important for your physical and mental health. Good sleep hygiene, in particular, can impact the quality of our sleep and improve our day-to-day functioning. However, what happens if your sleep hygiene is good but you’re still not getting a good sleep? Additionally, relaxation is important for Chronic Illness Warriors because if our mental health deteriorates, our physical health will as well (the body-mind connection). Pain increases with anxiety and depression, and there are lots of studies to support that, so relaxing (which helps anxiety) is another piece of the puzzle.

My parents dog was very relaxed there (and having a good sleep!)

I’m going to start with a product that I am currently using, which is the memory foam pillow. I first used one when I was visiting a friend awhile back and she had one. I found the pillow to be much more comfortable than what I was currently using. A few weeks ago I bought a memory foam pillow off of Amazon. Now, there are a ton of them on there. I bought a shredded one (again, going with what my friend had) but I imagine they have similar effects.

My memory foam pillow
  • What I like about it: It is extremely comfortable when lying on your back and the right balance between soft and firm for me.
  • What I don’t like about it: I’m a toss-and-turn sleeper, and it is much less comfortable when sleeping on your side and stomach (yes, sleeping on your stomach is bad and I try not to)
  • Would I recommend it?: Definitely if you sleep on your back, otherwise I’m 50/50 on whether it improves sleep.

The second product I want to talk about is the body pillow. I don’t have one but I’ve done reading on them and I’m convinced I want one. Also sometimes I line my spare pillows up next to me and use them as body pillows. They are apparently good for side sleepers, help back pain, and possibly release oxytocin in your brain (according to one article I read but I’m not 100% convinced by that). Apparently you have to be careful and get one that is the correct height for you. If someone uses one, please comment and let us know what your experience is!

The third product is weighted blankets. This is another product I haven’t tried but have heard amazing things about. I know a few people who use them and describe them as a “hug” and report that it does help their sleep. The thing to consider here is the weight of the blanket because you have to get one that is appropriate for your height/weight so you don’t get crushed but is also not just like a normal blanket. My former roommate had one that was too heavy for her so she gave it to her brother, whom it worked well for. Not only are they supposed to be helpful for sleep but also stress and anxiety, as they have some relaxation effects. If anyone uses a weighted blanket, a comment on this would also be lovely.

I have a birthday coming up so I’m likely going to buy myself either a weighted blanket or a body pillow (I’m not sure which one yet), so I’ll keep you posted on what I find. For now friends, keep making the most of it!

Top 10’s: Ways to Improve Your Physical Health When You Have a Chronic Illness

I will start off by saying that a “top 10” is no way a comprehensive list, because there are lots of ways you can improve your health (or at least keep it at base line) when you have a chronic illness. A lot of this I’ve learned through my own trial-and-error, through my studies and work in psychology/psychotherapy, and from conversations with other Spoonies and healthcare professionals. So, this is basically my Top 10 list, and I’m hoping you can pull a few things out of it if you haven’t been doing these already. I’m also going to link some of my blog posts and podcast episodes if you want to have a deeper dive into these topics. Also, I couldn’t determine an order for these, so they are not necessarily in order of importance (assuming there is one)!

Are you ready for my Top 10?!

Eating healthy. This is so important and often overlooked. Eating food that is organic and free-range is ideal, though if you’re like me this might not be affordable. If that’s the case, throw in some of that where you can and otherwise focus on the food groups, especially lots of green veggies. Limit your red meats, and of course limit any food that makes your symptoms worse (for some people that’s gluten or dairy). Be open to trying out different diets (Paleo, Keto) or fasting – but always consult with your healthcare professionals first. Check out this blog post on eating healthy, and this podcast episode on living with allergies.

Drink lots of water. 6-8 cups a day is ideal. I’m currently doing a challenge through Shape and Foster and part of that challenge is drinking 1.5L of water per day. Honestly, some days I really struggle but I also notice that the days I drink that much water, I drink less other stuff (that’s not healthy) and I feel the best. Water is important for our overall health and can’t be overlooked! I’ve got a blog post about it, and it is an essential of health which I discussed on the podcast.

Eat healthy, drink water.

Take your meds! Medication management can be super annoying but you’re being prescribed them for a reason, and there is typically a lot of science around them. I sometimes forget to take my meds (not going to lie) but again, I do feel best when I take them as prescribed. This doesn’t just go for Western medication either, try out some Eastern ones (head over to a naturopath, chiropractor, or other practitioner) to get some holistic care going. I’ve got a blog post about health management, and a podcast about holistic options.

Sleep hygiene. It’s so important for our physical (and mental) health to get a good sleep. Our bodies need to feel energized and rested when we wake up. Spoonies definitely have extra challenges with sleep. I often toss and turn because I’m never comfortable. However, doing proper sleep hygiene can at least minimize some of these problems and get your a better sleep. When I have proper sleep hygiene, I notice a 50-80% improvement in my sleep! No jokes! Check out the blog post and podcast episode for more.

Take your meds, get some sleep (or end up looking like this!)

Exercise. Yes, exercise definitely helps with pain reduction, and can increase things like mobility. There is a ton of science behind it. That being said, you have to be careful not to go over your limits (i.e., just push yourself to your edge but not beyond it) because you don’t want to hurt yourself. Low impact is recommended for chronic illness (walking, swimming, etc). If you’re not exercising, then just experiment with small amounts and gradually work your way up. This is another area that it is important to consult with a professional on. I do an exercise vlog post every 3 weeks, and I did a full podcast episode on exercise too.

Spend some time outdoors. Interestingly I just did a post on this last week that got very few views despite the fact that there is again science supporting how much this can benefit both our physical and mental health. Step away from the city if you can, even if just a few hours. Take the opportunity to breathe in fresh air. Tie it into exercise by going for a walk. Tie it in to stress reduction and just let yourself be. Though I don’t have an episode specifically about this, there is a podcast on holistic approaches that ties in nicely.

Exercise and spend time outdoors (my solo trip to LA, 2018).

Reduce your stress. Being calm, and having as little stress as possible (which I get it, sometimes just having a chronic illness is stressful!) is so important. Stress is a common cause of flares in many autoimmune diseases and in generally, always manifests into nasty physical ailments of one kind or another. This is a good reason to learn some mindfulness skills (which I do a vlog post on once a month). I did a whole podcast episode on how stress and anxiety manifest in the body as well – find it here.

Get involved in your care. This often means we have to be our own advocates for our health. That can include being a little “pushy” with our doctors (I mean it’s ridiculous that we have to sometimes but medical gaslighting is a huge problem). It also means that you may have to create a healthcare team for yourself. I’ve found this to be extremely beneficial for me. For more on getting involved check out this blog post and this podcast episode.

Reduce your stress and get involved in your care (and no this is not actually how I meditate lol)

Self-care. There are 5-6 dimensions of self-care (depending on who you ask) and physical self-care is one of them. A lot of the things from this list apply to physical self-care, but you can also add a lot more, depending on what you like – I like Epsom salt baths! I also mentioned that challenge with Shape & Foster earlier which this month is putting an emphasis on physical self-care. Hear more about them on the podcast. I do monthly premium blog posts for self-care which you can sign up for here.

Goal setting. No one can be expected to make any changes to any part of their life – including the physical aspects – overnight. That’s why setting goals can be really helpful. If you’re not currently exercising, then committing to 3 1/2 hour walks per week might a good place to start. Or increasing your veggie intake four times a week. Or spending time outdoors once a week. Whatever it is, make a plan and make it one that is challenging and yet you can stick to. I recently did a blog post on goal setting. This is the podcast episode it ties most nicely in with.

Spend time on self-care and set some goals (my goal to be a llama – jk!)

Okay, this was a longer post than normal but I hope you have a few takeaways! Keep making the most of it everyone!

How’s Your Pain Today?

I always have a million topic ideas in my head (well technically I write them down on Stickies because I don’t want to forget them) but I often end up going with something currently relevant to me because, well, it just makes more sense to. As I’ve mentioned before, in addition to fibromyalgia (and maybe lupus) I also have a tear of the anterior labrum (hip) – I’ll throw in a picture of what that looks like). This tear is brutal. Initially my rheumatologist told me that it could be taken care of with physio and if that doesn’t work, then surgery. She asked me if I’d like a referral to the surgeon, to which I said yes. This was March 2020. About a week before Covid-19 really went for it and we started shutting everything down, including “elective” surgeries (because is a surgery that will take away pain really elective?).

hip_labral_tear_intro01Image from: https://eorthopod.com/labral-tears-of-the-hip/

Anyway, the pain has normally been around a 7 in my hip. I’ve been doing physio (virtual) since the end of March and while my physiotherapist is amazing (check out my podcast), it also doesn’t really seem to be helping with this particular problem. Fast forward to last week Thursday when I leaned against a counter at work while I was talking to my boss… and I happened to learn right against the tear. Talk about excruciating pain running down my entire leg – hip to ankle! But I sucked it up and stayed at work and powered through. The pain now around an 8.

IMG_7670Even with pain at an 8 I can still enjoy the great outdoors (Niagara on the Lake, Ontario)

Fast forward to Monday, when I’m doing my normal hardcore workout. It’s an upper body one, so I’m not too concerned because my hip is normally fine on these workouts (sometimes I have to adjust lower body and full body workouts to accommodate my hip). Well, as I moved to get out a position, I heard and felt a “pop.” This seemed like my hip popped in and out of place (though upon some research I read that’s not really a thing that happens, so I’m not sure what exactly happened). Now the pain is a 9. I went to work Monday and Tuesday, and then got a doctor’s note for a week off from today (Wednesday) through next Wednesday.

Bfc1%ODwRQqrhxfVqJaK5QSpike is a good nurse.

So how can I still smile and laugh through all of this? First of all, that’s not always easy. I have to frequently change my position (standing, sitting, walking, lying) in order to feel comfortable because I can’t really be in any of them for too long. At the end of the day though, I can sit and feel sorry for myself (or be hard on myself because technically it’s my own fault it got worse) or I can (a) be productive and constantly call the hospital to see if they can do this type of surgery now, and (b) realize that pain, even chronic pain, is a temporary sensation. I can do meditations that focus on physical pain (which I did this morning), I can write a blog post, I can rest, and I can still have a life with this, because the other option is to not and I refuse to do that.

b32b0b08e2b74c9dab175157eea3f602Upo reserch, this is the type of surgery that needs to be done. Image from: https://orthoinfo.aaos.org/en/diseases–conditions/slap-tears/

How are you all feeling about your pain today?

Also, if you haven’t yet checked out my podcast – Chronically Living and how to make the most of it (Apple Podcasts and Spotify), the latest episode is on Pelvic Health. I would really appreciate some reviews and ratings for it (plus I have a little promotion going for that – see my Instagram @janeversuspain for more details).

Positive Psychology and Physical Illness

Before everyone starts hating on positive psychology, I’m going to give you a bit of a break down of it. As some of you know, I’m doing my Master of Arts in Counselling Psychology so I’m learning a lot about the different theories of counselling. Though I want to take an integrative approach in my practice, positive psychology is something that interests me. Here’s why:

  • the focus is on strengths, positive experiences, positive emotions (i.e., what’s good in life, not just what’s bad)
  • optimism and gratitude are encouraged (however, if you’re not an optimist then you shouldn’t be coerced into being one)
  • unrealistic optimism isn’t healthy, and neither is too much pessimism
  • emphasis on finding meaning in life and being authentic as it will lead to less stress and anxiety
  • there needs to be balance between positive and negative feelings and experiences
  • you can learn to shift your perspective from negativity to positivity
  • focus is finding ways to foster hope in your life
Word-ArtImage from: https://condorperformance.com/positive-psychology/

So what does this have to do with physical illness. Well, if it isn’t obvious already, positive psychology can help us shift our view of our illness(es) from being something that is terrible and completely disruptive of our lives, to something that we can draw strength and resilience from. Regardless of whether we are sick or healthy, we all have strengths (I would say mine are perseverance, optimism, and communication). We all still experience good things (fun times with friends and family for example), and positive emotions (unless you’re truly unhappy 100% of the time, you do experience happiness, love, contentment, etc.). This doesn’t mean we can’t have bad days or be unhappy, it means that we can choose to acknowledge the good days and the good things that happen as well.

XD0OdKzwQF2hBF41kefPEQEngaging in self-care kind of goes hand-in-hand with positive psychology.

I like the idea of meaning making (if you read my post on existentialism you’ll know this about me). So my original goal was to make movies and entertain. As my health deteriorated, I sought out new meaning and found that I want to help and inspire people (thus this blog, my podcast, and my new degree). The other part of this is finding ways to foster hope. I think that for people who are very sick, finding hope is difficult. I volunteer at a crisis text line for kids and teens. One of the articles I often send texters is on fostering hope. Here are some suggestions from the article: positive thinking, focusing on the future (and changes that will happen), look at the big picture rather than the details that are easy to focus on, remember your successes (however small – did you go for a walk around the block today? that’s a success), be patient with yourself because you’re doing the best you can, and reach out for support when necessary.

WsZ19goHSlyhimnYpy5C9QPursuing more education was an important step in finding my new life meanings.

Is positive psychology the only way to improve your mental health when you have a physical illness? Certainly not, but hopefully this was some food for thought.

Also, in case you haven’t heard, I have a podcast! It’s call Chronically Living and how to make the most of it. It’s available on Apple Podcasts! Check it out and please leave me a rating and review!

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Reference:

https://kidshelpphone.ca/get-info/8-ways-foster-hope-your-daily-life