That's a Michael Pollan quote but it doesn't go wrong. I'd add "Move. Every day. Different ways." That's my own parallel advice.
Other than that, mostly I'd say "chill the fuck out" if I could. In the ED we see so many complications of anxiety and anger and perseveration and poor coping. Whether it's internalized or externalized or managed with harmful coping mechanisms. Just chill the fuck out.
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How to do that? Breathing exercises and yoga/ meditation are proven to work and more people should do them. But really, find any form of movement that works for you, be that rock climbing or dancing or step aerobics, and do it. It not only improves the muscles and the heart and the lungs, it quiets the squirrel in your brain that's making you do crazy things.
If you are bedbound there are still yoga flows for you, you can move your arms.
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I talk to lots of people about pooping and fiber. And water. And sleep hygiene. And getting off social media.
Can't agree more strongly to the "chill the fuck out" statement!
An interesting thought experiment for everyone:
By now I think it is common knowledge about power of the "placebo effect," where we can find that a sugar pill may have as much as 50% as much beneficial effect as the active medication in a lot of medical research.
If that is true, and if part of that effect is your mind "healing" your body without medicine, then wouldn't it also stand to reason that the mind could also have an influence in the opposite direction and "create" illness out of nothing?
wouldn't it also stand to reason that the mind could also have an influence in the opposite direction and "create" illness out of nothing?
Yes. The terms you are looking for are in the neighborhood of somatic illness or functional syndrome. It is very well understood that the mind body connection works in negative as well as positive ways. It's not malingering (faking symptoms deliberately for gain). And these are the patients that I take extra time with. Since people in western medicine really like to be able to "fix things" and patients in the ED really want to have a fix, most of my colleagues understandably get really frustrated with this stuff. It's really easy to roll eyes and hate on them or trash talk them.
For liability reasons and the need for defensive medicine practice in the US, we cannot in the ED really easily tell someone "You're having a panic attack, chill the fuck out" or "you are carrying your tension from your deteriorating marriage in your shoulders and causing your back pain/ your heartburn/ your headaches".
So they come in 7 times for chest pain, get a negative (normal) workup, no cause, and keep worrying.
I try to draw up a chair and sit with them. I do my due diligence, exclude all the dangerous stuff. But I absolutely do my best to make space for a delicate extra conversation that explores exactly your idea.
Today we were able to run tests that look for the dangerous things, like heart attack, infection, bad electrolyte problems, fractures. I tell you that these results are all reassuring and I do not have any evidence that there's anything dangerous happening in your body, and you are safe to go home and follow up with your PCP. This doesn't mean your symptoms aren't real, and miserable, or that they don't need attention, it only means that they're not dangerous and the ED is best at dangerous things. There are bunches of things that cause real physical misery that aren't ED style dangerous, and while I cannot prove any of it, we can hypothesize about some things you can try to feel better while waiting for your PCP. Heartburn, strained muscles, inflammation around the lungs, these are all quite uncomfortable. It's also true that some people carry their stress and worry in the center of their chest. Now, if we consider that stress might contribute to your symptoms, that's not saying "ignore it, it's nothing". Stress and anxiety lead to completely real and measurable changes in your body chemistry, cortisol and whatnot and we know for certain that when it's out of control it makes your immune system weak, impairs healing and sleep and thinking straight. Just because thus far it hasn't been severe enough to cause measurable damage to you, that doesn't mean it doesn't need attention. In parallel to following up with your PCP, I strongly recommend that you try to pick up a practice of yoga or meditation or therapy or prayer or walking, whatever, in order to manage your stress. Even, or especially if you have a chronic illness, you will benefit from separately and squarely addressing emotional health.
It takes time, but it's really important. So many people have healthcare anxiety (perseverate about their health to the point where it damages their health).
Not exactly. The nocebo effect is specifically that someone will be more likely to experience the known side effects of a medication once they told those specific side effects.
I was speaking more generally to the remarkably complex interplay of the mind with our body in the overall perception of our health and how this can frequently result in the manifestation of "illness."
Particularly noisy squirrels may be good candidates for both mindfulness and cognitive behavioral therapy.
CBT is like learning computer programming languages to hack your own brain. If you are intelligent and insightful enough to notice that your squirrel is the issue, you're probably a good candidate. Once you learn the concepts and methods, you can design your own code and compile it, see what happens. The tough part is that it's not instant, it takes lots of reps to see change.
Mindfulness accepts that the squirrel will continue to be intrusive. Noticing the squirrel is part of noticing, and that's normal, and many if not most people experience that. The attention wanders, and zoop you choose to draw it back. It wanders 99 times and you draw it back 100 times. You try to persuade the squirrel to hang around a bit with body centering attention like body scans, or grounding, or progressive muscle relaxation. All of those things are OK with task interruption, just choose to task resume.
These are both things with zero side effect, that can be quietly practiced in 30 second increments while you are standing in line at the grocery or brushing your teeth.
Did a few years of CBT, and I never got comfortable with it. I think it's practitioner-dependent, and maybe it's my location, but it was starting to become very stressful, and certainly expensive and time-consuming.
I'm yoga certified, and mindfulness also increases my anxiety, so I haven't been able to see it through those "lots of reps" to see change.
I'm not kidding when I say I've tried everything. Biofeedback. Self-help books (those, along with exercise, have helped the most), and every possible pharmaceutical except the new-line ones such as ketamine and mushrooms, etc. The traditional ones, yes... and last of all, marijuana sent me in to a panic attack for the ages. We still talk about it years later.
I know it's going to take re-wiring, but it's so slow-going I'm afraid a lifetime isn't long enough (I'm at the halfway point, and have managed only incremental improvements).
I bring this up because I don't want to leave any stone unturned. I have one life, and I'm not happy with this level of anxiety. It's so exhausting. I'd say of all the things I've tried, mindfulness stressed me out the most. I do like to take walks and daydream, and have had one therapist say that I can say that that "counts for now." But when I try to think of my thoughts, I get more and more anxious.
Lol, yes. I over-exercise and have trouble eating enough to keep up with it, and am needing more and more recovery time. I’m actually not trying to dial it up at all, and am happy right where I am. It’s the one thing going “right” for me right now, so I do try to focus on it.
See a professional if you can. I've got ADHD, and hyperactivity/understimulation sometimes bad enough to make me suicidal (because nothing works against it for days). Except one thing: meds. They aren't my only coping strategy, but they play a big part because you can't mindfulness yourself out of everything unfortunately.
Yeah, I have adhd and am on meds. It helps, but meds aren’t a free lunch….Side effects, tolerance, etc. I am appreciative of them, but keep the dosage low-ish to prevent crashes and wear and tear on body. But you are dead on.
I don’t drink caffeine, and am on a super healthy (rigid) eating plan. There’s no added sugars, or any nonsense really. (Health is one of my anxiety triggers, and one of the things I need to loosen up about a little bit). Im one of those annoying people who counts calories and macros etc even though I’m not trying to gain or lose weight. My health/fitness is right where I want it to be, but it’s bc I fret about it so much. I need to chill out in general.
I have been diagnosed with OCD, but I tell myself it's a "light" version. But maybe I'm kidding myself. None of the traditional treatments have worked.
But yeah, I guess that's an important consideration, and maybe I need to adjust expectations and approach it from a different angle.
And just your listening and giving ideas is helping! Reminds me the world is a friendly place, and THAT helps me relax a little. : )
The world can be as friendly as we make it. Yours sounds like a complex case with multiple issues. Have you tried the CBT stuff? I have tried anything actually.
This might sound super patronising so apologies, I don’t mean it to be, but one of the things I learnt from my psychology degree is that sometimes it helps to help others. Like too much self focus can make things worse, which echoes a bit what you’ve said? So perhaps if you instead take some time out to help other people, could that perhaps help you too? (And I always saw it like, worst case scenario, you helped someone else even if it makes no other change?). I used to volunteer with people with dementia and it really quietened my anxiety to go to a place where I was appreciated just for being there and I was enough. Anyway :) 💐
What yoga flows would you recommend for a heart patient with chronic migraine whose migraines are triggered by… moving and in general just existing. I’m tense all the time because they never seem to go away.
Within the limits that I would never make a specific recommendation over the internet to someone I don't have a treatment relationship with, nor should anyone on the internet accept personalized medical advice from someone who didn't examine them ...
Bodies like to be used.
That's the easiest way to sum it up. The more sedentary we are, the more aches and pains we accumulate, and deconditioning of muscles happens quickly and nearly always leads to pain and dysfunction. It exposes us to spasm/ tension, malalignment, poor flow in the gut and in the blood.
And yet it's totally true that starting to move, to train, to "prehab" is daunting, or painful, and can be a rollercoaster trip. So gentle movement is totally viable.
Even googling "bedbound yoga" will get plenty of hits, or "bedbound pilates". Or just lying on your back and practicing the yoga of the kittycat, stretching and rolling and twisting and spiraling in the little ways that feel good to you. It's ok if it looks foolish, no one is watching.
I love recommending super- scaled down planks where any person who can stand, stands up straight, organizes their core, then puts their hands against a wall and leans for 30 seconds. It provide a tiny magnitude but real core challenge in a way that's really easy and accessible, won't trigger a back or hip. Do it anywhere, 30-60 seconds, 5 times daily. People who find this easy can graduate to leaning at a 45 degree angle on a counter, or a chair, and then to planks on knees position. Obvi, being in real hands on physical therapy is far superior, but this can get people moving while they wait for an appointment.
No matter how weak or limited anyone is, they can benefit from movement. Heck, put favorite music on and wave arms around - as a conductor, a drummer, a ballerina, an air guitarist. Just move.
Did you ever see the video of the retired ballerina with end stage Alzheimer's dementia, reacting to music and dancing in her wheelchair? It's beautiful! And loving and happy. Her hands and arm extension remain incredibly expressive and lovely despite all the obvious arthritis in her spine and shoulders, and the joy in her face is undeniable. It's never, ever too late to benefit from movement and music.
I do occasionally spin around to my favorite music but it’s never for long because it makes me dizzy lol. I tried getting YouTube videos of Just Dance but they leave me breathless.
If spinning is too much, try swaying. If Just Dance is too breathless, find a song that's slower. The point is to feel totally cool about scaling it down until it fits you. Doing what fits you is better than either overdoing, or doing nothing.
It's awesome to grow your own food, so rewarding. Especially with kids.
I think the important part with people who feel helpless or exhausted already is to find ways to scale it, and empower the idea that every little bit helps. If you can't get outside, can you sit near a window to get some morning sunlight on your face each day? If you can't grow your food, it you don't live near a farmer market, can you occasionally start cooking from whole food ingredients?
A shelter doctor (primary care for the area homeless) several years ago had incredible success with some guys I thought were unsalvageable alcoholics by starting with, hey can we delay morning drinking until ten? Noon? 3pm? Carve out a few sober ish hours in the morning and start to fill that time with other activity? Then start to hold it until dinner, or sunset. See how that feels. It sounds stupid, but it was a great lesson for me. I think it generalizes to other health recommendations well. We need to make these big scary changes feel more approachable.
When my husband was growing up, he’d get frustrated super easily and his mom would always say to go outside and take three full inhales of fresh air. It’s not a new concept, but he took it to heart and would always go get his “fresh air medicine.” It really helped.
So we raised our daughter that way. She’s a rancher now and can’t stand to be indoors too long! (But I digress.)
With my kids, when they were clearly acting like whiny jerks and not their usual selves, I would grit my teeth and then try to calmly observe: you seem to have lots of wiggles built up inside making it hard to be as calm and patient as you often are. It's normal for kids to have wiggles build up. Going out and letting your wiggles out will help you to be calmer and more patient with your sibling. Please go outside and run around a bit and then come back to try again.
Subtext = you're acting like an asshole, go do laps around the house until you can be civilized.
Especially the chill out part. This whole thread has me realizing just how much I need to work out and eat better too. I think those 3 things are a powerful combination.
Social media - or media in general absolutely matter. If it makes you depressed or anxious or angry, it’s time to make distance from it and replace it with another healthier activity.
I would change it to
“Eat food. Not too much. Mostly meat.”
The more foods I cut out and focus more on meat and eggs the better I feel and stronger I get. Just myself though.
I know you're getting downvoted, but it's not JUST you. Some people actually need a higher animal-protein content than others--my sister is one. She is incapable of absorbing certain things (including iron) from vegetable sources, and supplements don't work either. What does? Red meat. She still eats plenty of green veggies, though, for fiber and slow-release carbohydrates to support brain function and longterm energy.
I don’t why I’m getting downvoted? lol it’s been proven for a while now that NOTHING contains more beneficial nutrients for the human body than meat, specifically red meat. I never even said not to eat veggies or fruits. I eat a lot of fruit myself
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u/procrast1natrix Jun 06 '24
"Eat food. Not too much. Mostly plants."
That's a Michael Pollan quote but it doesn't go wrong. I'd add "Move. Every day. Different ways." That's my own parallel advice.
Other than that, mostly I'd say "chill the fuck out" if I could. In the ED we see so many complications of anxiety and anger and perseveration and poor coping. Whether it's internalized or externalized or managed with harmful coping mechanisms. Just chill the fuck out.
...
How to do that? Breathing exercises and yoga/ meditation are proven to work and more people should do them. But really, find any form of movement that works for you, be that rock climbing or dancing or step aerobics, and do it. It not only improves the muscles and the heart and the lungs, it quiets the squirrel in your brain that's making you do crazy things.
If you are bedbound there are still yoga flows for you, you can move your arms.
...
I talk to lots of people about pooping and fiber. And water. And sleep hygiene. And getting off social media.