Chronically Living and how to make the most of it

Anxiety & Chronic Illness

March 07, 2021 Kelsey Season 1 Episode 37
Chronically Living and how to make the most of it
Anxiety & Chronic Illness
Chapters
Chronically Living and how to make the most of it
Anxiety & Chronic Illness
Mar 07, 2021 Season 1 Episode 37
Kelsey

In this episode we deep dive into mental health, and specifically look at the overlap between anxiety and chronic physical health problems, as well as some ways to deal with anxiety.
In this episode we talk about:

  • my experiences with anxiety and chronic illness
  • difference between fear and anxiety
  • overlap between anxiety disorders and chronic physical health conditions
  • psychotherapy for treating anxiety about your health
  • body scan

I would love to hear from you on Instagram! Tag me @janeversuspain.

Show Notes Transcript

In this episode we deep dive into mental health, and specifically look at the overlap between anxiety and chronic physical health problems, as well as some ways to deal with anxiety.
In this episode we talk about:

  • my experiences with anxiety and chronic illness
  • difference between fear and anxiety
  • overlap between anxiety disorders and chronic physical health conditions
  • psychotherapy for treating anxiety about your health
  • body scan

I would love to hear from you on Instagram! Tag me @janeversuspain.

Kelsey Harris:

Welcome to the chronically living and how to make the most of it podcast. I'm Kelsey Harris, a chronic pain warrior here to inspire hope and strength to the spoonie community, get ready to lift each other up and find ways to live the best life possible. Welcome back everyone to chronically living and how to make the most of it. So this week, we're going to do a deeper dive into our mental health. Now, some of this is definitely going to apply to you whether or not you have a chronic illness. So definitely worth listening to, I am tailoring it a bit towards the chronic illness piece of because of course, this show is for the spoony community, so it kind of makes sense to do that. We're really going to focus on anxiety this week. Now there is a lot of overlap between anxiety and depression. And it's pretty common to have both, but because they're such big topics. And, you know, I'm also a mental health practitioner, just doing my practicum right now I decided that I'd separate them into two different episodes. So at some point in the future, I will do an episode specifically on depression and chronic illness as well. But yeah, we're going to start with anxiety. So I want to start by recapping my own story with anxiety in relation to my chronic illness. So I was initially misdiagnosed actually was misdiagnosed twice, but the second misdiagnosis was closer to a real, the real diagnosis than the first one. So we'll just say I was misdiagnosed once. So that was back in 2016. And that diagnosis has as that was for lupus, so they my rheumatologist diagnosed with lupus a little prematurely maybe. And that diagnosis has been updated now to undifferentiated connective tissue disease, which I'm hoping to do an episode on with a couple other people in the near future. Um, so now at the time, I started to develop a lot of anxiety. And that anxiety just got increasingly worse over the next six months following my diagnosis. So some anxiety is completely normal. We all get anxiety from like bills or stress from work, stuff like that, you know. But my anxiety was like extending beyond like normal stuff. And it was really more about my health, and then eventually kind of like fear that my relationship would end because of my health. So spoiler alert, it did end. But I actually think it was more because of my anxiety and mental health as well as her own issues. Then because of my physical health. So anyway, this anxiety got worse and worse. And then my relationship ended. And during this time, my physical pain was also getting worse and worse. And then ended up in the ER for pain. And then after that I made some drastic changes in my life by assembling this amazing healthcare team. And I've had them on the show. So episodes 5, 9,21 and 22, if you're interested in listening to them and what they have to say. And then I also at the same time, got myself a psychotherapist, because I wanted to start dealing with that anxiety. And when all I can say is like, Wow, what a difference that did not make on my life. to not have to deal with anxiety, like that was just amazing. And just continues to be amazing. But it also took like a lot of hard work on my part. So I'm not going to today present you with like a miracle cure to get rid of your anxiety. We're going to talk about some ways to help, but you have to do pretty much the majority of the work to make that happen. Okay, so fast forward. Now I'm working as a psychotherapist, which is unpaid at the moment as I'm doing my master's. And yeah, so it's like a practicum internship type program. And I do have like a caseload of clients, which is I'm really enjoying, by what I've learned by actually having clients is that there's a few things that I think I want to clarify with my listeners here you guys before we move forward because a lot of people don't really seem to know these things and they're really important for understanding your mental health. So first, there is a huge difference between adaptive fear and anxiety. So fear is literally essential to our survival as a species. If we are actually in danger we need to either like run or fight so that that flight or fight response and sometimes when it comes to health, we are actually just experiencing fear like we need to protect ourselves. You know, and, or, you know, if you're pregnant, like, and you have some anxiety, but may actually be fear of some things might happen to your child or like some of the is just normal and necessary, because if we didn't have that fear, then if you cut your finger off, you wouldn't go to the hospital, you know, like if you, you know, are having difficulty breathing, you wouldn't call 911. Now, of course, difficulty with breathing can also be associated with anxiety and panic attacks. So be a little careful there. But you know, there are there are reasons that we have fear, and it is important. Now, anxiety, on the other hand, is when that response starts to become a problem. So anxiety is an overestimation of the danger we are faced with. So it's, we're thinking it's way worse than it actually is. And an underestimation of our ability to cope with that danger. So we don't think that we can do anything to help ourselves, actually wrote a blog post on kind of touched on learned helplessness recently, as well. So it's kind of interesting, these two things tie together slightly. So anxiety brings us outside of our window of tolerance, which is like this space within us that we feel in control. And it brings us out so that we don't feel in control anymore. So when we're talking about anxiety, today, we're not talking about responses to situations that makes sense for us to respond that way to, like fight or flight that's gonna protect us, but we're talking about the ones that don't make sense. So let's review some research before we move any further ahead, because we always review some research. So according to El-Galabawy, I definitely butchered that name, et al. from 2011, it's really common for people with chronic physical health conditions to have an anxiety disorder as well. It's also really common for people with an anxiety disorder to be more at risk of developing a serious medical condition and go on disability because of sad condition. And as you have more physical health conditions, you are likely to have an increased risk of having an anxiety disorder. And then having both an anxiety disorder and a physical health problem leads to poor self rated physical health. So you actually view your physical health as being worse. And or it is actually worse than if you just just have the physical health condition, for example. And to be clear, when I say anxiety disorder, I'm talking about a diagnosis based on either the DSM 5, absolutely the Diagnostic Statistical Manual, from the American Psychiatric Association, United States or the ICD 10, which is put out by the World Health Organization. So, these diagnoses are typically done by a psychiatrist or a GP. So for example, someone like me would not make a diagnosis will have an idea of what it could be, but we wouldn't make it. And you don't need a diagnosis, even if you're experiencing a lot of anxiety. Or any other mental health problem that's not super severe. Like To be honest, I think we over pathologize sometimes. So that's just my opinion. And then there's a bunch of additional research that comes from a variety of other sources. And that indicates that people so there's a couple things here so one is that almost half of all people with cancer have symptoms of anxiety, such as worry or panic attacks. And people with chronic pain are three times more likely to have symptoms of anxiety than the rest of the population. Some common symptoms of anxiety when you have a chronic illness are excessive worry about your physical health, trouble sleeping, so either worry that keeps you out or nightmares about your health. Panic attacks, again, related to your health, trouble talking about your physical health, avoiding treatments, because they might cause you some anxiety and or social interactions in general. Having thoughts about death, and just generally being irritable, which is a pretty common sign of anxiety and depression. Okay, so now that we know it is that it's more likely for you to have anxiety if you have a chronic illness. I just like I hope this kind of normalizes it for you a bit if you are having anxiety. It's not you're not alone. So what can we do about this anxiety? Well, of course I'm going to suggest therapy, which is definitely worth budgeting. If you can, and also, I just want to point out that depending on where you live, you can get it for free or on a sliding scale. So sliding scale means that if you can't afford, like the regular rate, they will sometimes charge people based on income less. And there's lots of community health places that do that. Pretty much in every city in North America, for sure. I'm not sure about Europe, in the rest of the world, but definitely North America. And then there's also places that do it for free. So I work for a government funded agency that covers the government covers therapy for people who qualify for it. So you qualify for it if you're not covered by insurance. The only thing with that is that wait lists typically are pretty long. So you'd have to wait longer to get into treatment and treatments, more short term, select six months, so really depends on what you need and what you're looking for. So I practice what's called Acceptance and Commitment Therapy, which is part of the third wave of cognitive behavioral therapy. I'm sure many of you have heard of CBT, it's kind of the most common psychological treatment, because there's a huge evidence base for it. And there's a lot of evidence supporting the use of ACT with chronic illness and chronic pain, as well as anxiety and depression. And since I'm trying to specialize in chronic illness, because of the overlap with anxiety and depression, it really makes sense for me to to use this approach, and I did some initial training on it, and I just fell in love with it, I thought it was made so much sense, especially when we're talking about like chronic illness and chronic pain. So I'm gonna give you a brief overview. There are six elements in ACT. First is the present moment, which involves being very aware and present. And that's through the use of things like mindfulness and relaxation. And when I say mindfulness, I don't necessarily just mean meditations. There are other mindfulness exercises that are really utilized enact even yoga. So it's very inclusive. The second is diffusion, which is challenging our negative thoughts and beliefs, and separating ourselves from them. Which is not always easy to do. The third is acceptance. Because in reality, we can't get rid of all of our pain, whether that's physical or mental, it's, it's impossible for anyone to live pain free. So instead, what we want to learn to do is, is learn to hold our pain, so that it has less control over our lives. The fourth is self is context, which is understanding that we are not our thoughts, and we are not our pain. And the fifth is, values are figuring out what we want out of life, that meaning in life. You know, and I've gotten kind of episodes on this. And I've had some guests talk about this stuff, too, in the past. So it's really like figuring out what, what we want our lives to mean, what we want to do with our lives, and what's important to us. And then finally, we have committed action, which is taking steps that are within our control to get the life we want. So if you want a book recommendation, that is meant for like the general population that kind of discusses all of this stuff, I recommend the happiness trap by Dr. Russ Harris, who was of no relation to mine, to me, but I wish I kind of wish he was. I really like his videos on YouTube. But yes, that is a great book. He does also have a lot of videos on YouTube that explains a lot of this as well. Yeah, I also want to state that the outcomes of psychotherapy are based on a couple of things. As I mentioned earlier, that I put a lot of work into reducing my anxiety. And I'm gonna explain what that means. So there's basically four elements of outcomes in psychotherapy research. So the first is the relationship between yourself and the therapist. And that accounts for 30% of of how well you're going to do. So you've really want to make sure that you have a therapist, that is right, this is the right fit for you. The therapists own skills account for about 20% of the outcomes. So experienced doesn't matter as much, but it does matter a bit. So you know, whether that plays into your choice of therapist or not, you know, that's kind of up to you. techniques. So whether you're a therapist, your therapist uses ACT or traditional CBT, or psychodynamic therapy, or really any other kind of therapy it only counts for about 10% of your outcomes. So just see a therapist regardless of kind of what their specializing in now there's some evidence that supports things more than others for especially for certain disorders. But it doesn't necessarily make a huge difference. And then *coughs* I'm sorry, guys, the most of the outcomes so that remaining 40% they actually come from you. Your effort and practice and work on yourself is extremely important in making your life better, so that you can make the most out of your life. Please don't forget that. I think that in addition to psychotherapy, just making sure you have a solid healthcare team, and that you're getting support, either from a support group or just like an online community, like on Instagram, if you you know, hashtag spoony, your chronic illness or chronic illness warrior, you're going to find all these amazing people. And that can be very beneficial. Today's quote is from Winston Churchill, he said, when you're going through hell keep going. And I think that's all we really can do. But you know, sometimes we need some help to do it. And if you're struggling, please ask for help. So we're going to end today on a short body scan. So this is going to help you increase that present moment awareness and learn to be okay with some physical discomfort and a lot of people do find it a bit of a relaxing process as well. So if you're able to please close your eyes and inhale to a count of four, hold for three. Exhale for five. And then one more time on your own. Let your breathing return to normal. And focus your attention on the top of your head. What do you notice? don't change anything Just be aware. Now move your attention to your forehead and eyes. Notice the sensations drop your attention to your jaw. And if it's tense, you can either relax it, we're just noticed that it's tense. Move your attention to your neck and your shoulders. How do they feel? now focus on your arms. Upper, lower, wrists, hands and fingers. Notice all sensations that are there. Move your attention to your back. First, your upper back and your lower back. Notice any tightness or tenseness or other sensations. Shift your attention to your chest and your abdomen. Just notice your breathing without trying to change it. What does it feel like? Now move to your pelvis and your hips. Just feel the chair ground beneath you. Drop your attention to your thighs, knees, calves be aware, aware of whatever's there. And finally, drop your attention to your ankles, feet and toes. Just notice how the ground feels beneath you. Now just take a few moments to notice your body as a whole. When you're ready, open your eyes. I hope that helps with some relaxation and awareness today. If you have any questions about any of this, please feel free to reach out to me on Instagram. And then just take me with any takeaways you have from this episode and your story I'd love I'd love to hear from you guys what you you know what you like what you don't like and and same thing you know with reviews if you just let me know what you're enjoying or not enjoying or want to hear about on the show that really helps me put together episodes and I do have some more interviews coming up with some spoonies and some healthcare professionals and I definitely want to bring you guys all more thoughts. All right, so for now, just keep making the most of it warriors. Thank you so much for joining me today on the chronically living podcast. If you love this week's podcast, please subscribe, rate and leave a review. Until next week, stay strong