During this challenging time many journalists, healthcare professionals and individual members of society are talking about mental health and how it is being challenged with loss of financial security coupled with social isolation. Is there a silver lining in all this? Maybe so, since conversations about mental health have traditionally been closeted as something to be hidden from general public discussion. The mind is considered a personal realm - something we can and should be able to control - more so then the thyroid, kidneys or heart. There are no reservations mentioning that a new blood pressure pill is prescribed, but a new anti-depressant would rarely be divulged.
The idea that the mind is completely separate from the body has been challenged and demonstrated to be inaccurate. Research in the last two decades has demonstrated a clear connection between chronic inflammation in the body and mood disorders such as depression and anxiety as well as cognitive disorders such as Alzheimer's. Additionally, the converse is true. Negative thinking, chronic anxiety and depression can cause chronic inflammation in the body. There is a bidirectional flow of information - the mind effects the body and the body effects the mind.
The idea that the mind and disease processes are linked is not new, actually it is ancient. Hippocrates noticed that certain personality types correlated to specific diseases (Zozulya et al, 2007). Modern research suggests that "passive" (Type C) coping styles are more likely to develop infectious diseases and cancer whereas "active" (Type A) coping styles tend toward coronary, allergic and autoimmune diseases (Zozulya). So, being either too passive or too active can lead to chronic inflammation and disease. Finding coping strategies that promote a sense of personal resolution is not only better for the mind, it is better for the body, too.
We are now able to say that depression is the most significant mental health issue facing society today. A common thread in depressed thinking is a tendency to direct attention toward negative information (Maydych, 2019). According to Maydych, recent studies show correlation between inflammatory markers and attention to negative information - suggesting a neurological pathway between stress, depression and inflammation.
When I studied bio-psychology in college, I learned that the brain has certain pathways that are created and these become the default pathways to certain stimuli. For example, let's say that when I was a toddler I saw a bumble bee and said "pretty!" and grabbed it in my hand. The bee stung me, it hurt, I cried. Flying bugs were associated with pain. The resulting pathway was simple:
Flying bug = pain = fear of flying bugs
This is a true story and for many years I had an irrational fear of flying bugs. Today I am able to walk outside without running crazily away from anything small with wings. As I grew a little older I was able to differentiate between flying stinging bugs and non-stinging bugs. I changed my pathway to remove flies, butterflies and moths from the fear category. As I continued to age, and had many other encounters with bees and wasps that did not result in pain, eventually I was able to reform the pathway in my brain. This is a very simple explanation of brain pathways. People develop associations that are far more complicated. The good news is that these pathways can be changed, just like my fear of flying bugs.
So, what do we do about this?
Sharon Begley wrote a great book called "Train Your Brain, Change Your Mind." In it, she shares the relatively recent research that proves the brain can reform pathways and even make new ones. By intentionally training our brain, we can change the pathways. But, remember that not only does stress and negativity cause inflammation, inflammation causes stress and negativity. So, in addition to training our brain to think positively, we have to change our inflammatory behaviors as well.
Here are a five simple steps to help create more positive thinking:
1. Keep a journal and write out your frustrations/anger.
I am reading a book by Paul Pearsall called "Write Your Own Pleasure Prescription." In his book, one thing he talks about is how writing out your frustrations can help slow and calm you down. He encourages people to keep a journal and to write things down at work or home when feeling angry or frustrated. It is helpful to go back and reread what you were frustrated about and gain some insight regarding what upsets you.
Rather then indulging your anger in the moment, disconnect and go write about it. Take the time to reread your journal entries and really study what you write. Look for the thoughts that you have about life and people which trigger your anger. Recognize that you can not change people, you can only change how you react. Next, write down the feelings you have when you think those thoughts. Usually thoughts are cynical and this triggers anger. Finally, write down how you behave when you are angry - slamming doors, shaking fists, yelling or shutting down. As patterns emerge, think about alternative coping strategies that can lead to more positive thinking for yourself -- do not worry about being right in a situation or getting your point across to someone else.
By recognizing negative thinking and replacing it with positive thinking, you are literally rewiring your brain and ultimately decreasing inflammation.
2. Decrease or stop eating/drinking sugar.
Remember that the body effects the brain. We know that sugar can cause highs and lows, increase appetite, lead to inflammation, cause altered gut microbiome and obviously is not great on the waist line. Instead, seek out recipes from trusted sources, like Dr Mark Hyman, and make your own healthy desserts. Here is a link to chocolate truffles: https://drhyman.com/wp-content/uploads/2016/03/Chocolate-Truffles-with-Coconut-Oil-A-Giveaway.pdf
3. Stop drinking alcohol for one month, then restart but only occasionally.
I Know! I'm asking a lot! Alcohol is often used to sooth our emotions, take the edge off when stressed out or as a way to reward ourselves for a hard day's work. The problem is that alcohol effects the gut microbiome - it is a sugar, after all. It also causes the munchies and makes us less able to really engage in true stress relieving activities. We just put everything on hold when we are drinking, and we wake up to the same emotional stress in the morning.
Instead, look up a recipe for a mocktail -- they are VERY popular now! Here is one that is perfect for relaxing: https://www.foodandwine.com/recipes/cucumber-lemonade-mocktail
While sipping your mocktail, maybe work on writing positive affirmations in a journal, color, paint, take the time to reconnect with friends, sit outside and watch ants or birds or the clouds. Stay engaged with your relaxation and de-stressing activities with a sharp mind. Recognize that you are providing self love and letting go of the day in a way that is decreasing stress and inflammation in your body.
4. Establish a bedtime routine and stick to it.
A bedtime routine includes no screen time for one hour prior to bed. Screen time is directly linked to decreasing melatonin production. Bedtime activities can include an epsom salt bath, 20 minutes of meditation or calming activity, reading a book, getting a massage from a loved one, snuggling intentionally with a pet or some yoga. A hot epsom salt bath is both is calming and detoxifying.
Meditation - even just deep breathing activities - can allow for a peaceful transition between the day and night and can promote healthy sleep. Interestingly, a connection has been found between meditation and melatonin. Individuals who meditate have higher levels of melatonin than those who do not. This is important because melatonin is known to be a powerful anti-oxidant and can decrease inflammation, anxiety, and pro-inflammatory substances in the body.
Melatonin levels begin to rise in the early evening and peak between 9 and 10 pm in adults, then decline as the night continues. Optimal rest is achieved when a body is in bed ready to succumb to sleep when melatonin levels peak. Staying awake and getting a second wind can result in loss of precious sleep hours which are much needed to decrease inflammation and promote a positive outlook.
Okay. So we all know that exercise has many health benefits, but did you know that exercise improves stress, anxiety and depression, decreases inflammation and improves immune and cognitive function? What is important to recognize is that exercise should be just as individualized as all other health care recommendations. What is right for one person may not be right for others.
Exercise is just movement. Finding your best path to exercise and positivity is learning to honor and listen to your body. Get out and move in the way that works best for you and pay attention to how you feel. For some people starting out with a nice long walk may be best, for others kicking it up a notch and sweating may be the ticket. Right at this moment in time there are an unprecedented number of ways to work out from home. All you need is a bit of room and internet. Personally, I watch the GymRa Transformation videos on Amazon Prime.
My favorite instructor is Jada Kelly. Here is a link to her YouTube Channel: https://www.youtube.com/playlist?list=PLsPcs4lOzaD11Itd0oBFN3CN2sKQgZ6E9
There are other YouTube channels as well. Here is a list of the top 10: https://www.cnet.com/how-to/youtube-fitness-channels-for-getting-in-shape/
There are also meditation videos on YouTube. Here is a ink to one: https://www.youtube.com/watch?v=W19PdslW7iw
So to sum it all up, now more then ever we have the social attention needed to talk openly about mental health issues and how to address them from a medical stand point. We know that the mind is a part of the body just like the thyroid, liver and heart. A positive outlook from the mind can be likened to positive insulin production from the pancreas! It is all connected, and it can all be influenced by decisions we make on a daily basis.
The mind and body are ultimately very forgiving - once we decide to commit to anti-inflammatory lifestyle decisions, the body will respond and decrease inflammation! Pathways are changeable. Negativity can be transformed into positivity. Thoughts can be a powerful tool to help create a sustainable change in both the body and mind.
Gina Ditta-Donahue is a certified Family Nurse Practitioner and Anti-Aging Medicine provider. She is the author of "Josh's Smiley Faces: A Story About Anger," a children's book aimed at helping young children and their parents navigate anger management and build adaptive life skills. She is also co-owner of Elevate Functional Medicine.
Maydych V. (2019). The Interplay Between Stress, Inflammation, and Emotional Attention: Relevance for Depression. Frontiers in neuroscience, 13, 384.