stress

Journaling with IBD: A Focus on Mental Health

During 2020’s intermittent quarantine, what has brought me more solace than anything is the act of journaling. As someone who was diagnosed with Crohn’s disease during the pandemic, much of my hospital experience was drastically different than others. Increasingly isolated from my loved ones, I could feel the weight of my diagnosis crushing me, the four walls of my hospital single closing in. 

For IBD patients specifically, mental health is tied so closely to our physical health. I’ve had days where my physical flare-ups make me double over; it’s no coincidence that those same days, my mood swings and sensitivity levels are out of control. In fact, this phenomenon is so common that there’s an actual term for it: the gut-brain connection. 

The gut-brain connection refers to how changes in our gut can have drastic impacts on how we feel and behave. Many tend to dichotomize our bodily systems, finding it hard to believe that our behaviors and moods can be swayed by what we eat and how our gut reacts. This is explained  by what’s called ‘bi-directional’ communication, in which our gut and brain talk to each other using different pathways. 

Re-focusing energy is powerful. With enough time, journaling can become a way to channel your energies into finding peace and introspection. What’s best about all this is that journaling can take any form you want it to. It’s simply a way to get your thoughts out on the page. Humans absorb so much information and stimuli during their waking hours; life, as it turns out, can be overwhelming at any point in time, regardless of an IBD diagnosis or not. 

Journaling should be a way to relieve stress, a way to declutter your mind. I’ve found it especially helpful to process my physical and mental pain; even doodling can help distract your mind for a few minutes. Especially for patients with IBD, a journal can be a place to record symptoms, reflect on treatments, or even track what foods you’re eating (Check out this article on how to start a food diary by David, a 2021 CCYAN Fellow!)

All you need is a notebook, even just a piece of paper, and a pen or pencil. Some people find it helpful to pair a journaling session with a few minutes of meditation: this is your choice! Whatever makes you feel the most grounded and relaxed. 

Here are a few journaling prompts to get you started:

How are you feeling right now? 

What does your body need? 

What is giving you energy? What is taking your energy?

What are you grateful for, at this moment?

What are some themes in your life right now? (rest, peace, healing, etc.)

Things that feel heavy today; things you can try and release today.

What do you need to let go of in order to move forward and grow?

What beliefs and assumptions are holding you back?

What do you have to be proud of? 

Where are you feeling stuck? Where are you feeling growth?

IBD and Anxiety

IBD and anxiety

When you are first diagnosed with Inflammatory Bowel Disease you learn quickly that the brain and gut function as one. They are deeply connected. Even if you don’t have IBD, you can look to feelings like butterflies in your stomach when you are nervous, excited, or in love. IBD has given me the superpower of identifying an instinctual trust of my gut. One thing you commonly hear when talking about how to manage your IBD is that you have to manage your stress levels. Since the brain and gut are so connected, the chances that a flare up will occur when you’re stressed are high. Truthfully, being able to manage your stress is a very privileged thing to be able to do and that’s a conversation that needs to be had. Outside forces and systems of oppression exist heavily in our world today. We are not functioning in a world that allows you to thrive and prioritize both your mental and physical health. For most people, there is always a tremendous amount of stressors that you cannot escape. Things like finances, unstable households, going to school, and working all cause a great deal of stress. 

Today, I want to specifically talk about how managing stress levels and IBD feels increasingly impossible when you have clinical anxiety and/or PTSD, as these are so often linked with IBD. 

I was diagnosed with IBD at a young age. My physical health was always prioritized over my mental health. This was more pronounced, I think, because mental health is not a thing that is necessarily often invested in for young children. As a child, it was very difficult for me to identify what I was feeling and what triggered these feelings. Specifically, with my anxiety, I did not know what a neutral state of mind meant. I didn’t know what my anxiety looked or felt like till around my sophomore year of college. After going on anxiety medication for a bit, I was able to understand what intrusive thoughts were and how they occupied my life. 

The baseline for my anxiety is intrusive thoughts, but it can also manifest itself in different ways just based on the things I am doing in my life at the time. For example, my anxiety can manifest itself in ways such as crying in social settings, having an obsession with time (i.e. constantly looking at the clock or leaving hours early for events), and, when things are more extreme, staying in my room for days on end. For me, it is so important to specifically state how my anxiety manifests because for so long I did not know what it meant. I think it is important that we normalize talking about everything that anxiety can bring with it, not just generalizing or downplaying it. So often, I think anxiety is talked about in very loose terms and given very simple fixes for how to “handle it.” This, in return, can oftentimes belittle the situation. 

When these more intense and intrusive moments occur, my IBD flares up. So, I often question how I am to manage my stress when I often cannot control my anxieties. In the past, I would become stressed when I experienced my anxieties because I did not know what was wrong. Now, they still stress me out, even though I know that it is anxiety. 

For me, and I think many others, anxiety is something that I have to constantly cope with on the daily. If I am not ten steps ahead of it, it will simply swallow me whole. 

IBD and anxiety can feel overwhelming and scary, but what has helped me is knowing that I am not alone. Having these two conditions together is not uncommon, and what feels very isolating and full of despair is not the case. Medication has helped me in the past and therapy is a forever process for me. I also keep a bullet journal of coping skills I have used in the past - identifying coping mechanisms that worked and ones that did not. This list gives me a place to turn to when I feel as though nothing could help and it's easily accessible. I have also found solace in being in a community of people who understand. Explaining anxiety or IBD to someone who has not gone through it can be very exhausting and this goes for many other varying identities as well! When I do find the energy, making art is another space for me to process my anxiety, whether that be through a conceptual piece or just painting a canvas with one color over and over again.

What are ways you cope with your anxiety?

Stress, Its Effects on IBD, and How to Handle It

By Erin Dunne

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We all have had moments where it feels like everything is happening all at once. Whether that be good or bad, it can be extremely overwhelming. With school and work, it may be projects piling up, exams, or a packed schedule. In our social lives, we may have weddings, plans with friends, and family events that happen within a short time frame. We may think of stress as a superficial, short term feeling that goes away once the chaos has subsided, but that is not always the case. The effects of stress can stay within the body for hours and sometimes days after the stressor has vanished. The intensity of the body's response depends on the individual and how they handle the stressor- either focusing on their emotions, avoiding the situation, or nourishing themselves and acknowledging the issue. It is essential to understand the different types of stress, how each variety can affect the body, and how to handle yourself when faced with such situations. Knowing what to do is not only beneficial for your overall health, but it makes you feel powerful and amazed at the control you can have over the situation!

What is stress and what does it do to the body?

Stress is the body's response to any situation that poses demands, constraints, or opportunity (Riehl, 2019). There are two main types of stress that people face: Acute and Chronic. Acute is short-term and is most common. An example would be daily occurrences such as a project deadline, or being stuck in traffic. Chronic stress is prolonged and can contribute more harm to the body if experienced too often. An example would be involvement in a toxic relationship. When the body detects a threat, the brain activates the sympathetic nervous system which stimulates a response typically known as the "fight or flight response." The sudden release of hormones, primarily adrenaline and cortisol, prepares the body to take action. When the rush of hormones is constant, this can cause a lot of wear and tear on your body. Once the alert phase is activated, the goal of the body is to return to its natural, parasympathetic state with regulated hormone levels.

When in "fight or flight" mode, the body focuses all of its energy into systems that are necessary and shuts off others that are not being used. One that becomes restrained is the digestive system. While there is no direct correlation between stress and IBD, more research has been conducted to investigate the influence of stress triggering symptoms. Ongoing stress can often go unnoticed, but it continues to impact the function of certain systems of the body. Stress is hard on the digestive system, as it affects which nutrients your intestines absorb, and how quickly food is moved. A recent study has found that IBD symptoms may increase because the sympathetic nervous system acts on the lining of the colon and may worsen current inflammation. Evidence has also led scientists to believe that stress hormones may help harmful bacteria reside in the intestines (Norton, 2010).

What causes stress?

This reaction is initiated by the presence of stressors, anything that triggers a physical response. The causes of stress differ for each individual- we all have our unique threshold and perceive situations differently. For example, if there is a presentation that requires the student to talk in front of their class, one person may not mind public speaking and are not worried about presenting, while another student may dread public speaking and feels exceptionally anxious. Of course, not all stress is bad- an example of good stress would be the feelings you may experience before an athletic event. Some common stressors include school, work, busy schedule, traveling, finances, lack of sleep, and poor diet.

How to handle stress:

Generally, there are two types of coping styles; Problem-Focused and Emotion-Focused. People who are Problem-Focused approach the issue head-on, whereas people who are Emotion-Focused tend to lean into distractions and avoid the issue. It is critical to recognize what coping style you tend to resort to naturally so you are more prepared when faced with a future problem. You are also able to understand yourself better! Regardless of your natural response to a stressful situation, it is also essential to know how to take a break amid chaos. Taking a break allows yourself to calm down and assist your body back to its normal state.

Stress reduction techniques can help you find peace and maintain perspective when consumed by pressure. It is vital to find something that appeals most to you- what works for one person may not work for another. Trying out a few different techniques can help you see what works best for you and can quickly become your go-to reaction to stressful situations. Some great things to incorporate into your stress managing tool-kit include: incorporating physical activity, talking and spending time with friends, reading, and baking. Even taking the time to focus on your breathing when you find yourself becoming overwhelmed can help manage the intensity of the stress response. Finding an activity that stimulates rest, clears your head, and makes you happy is one of the most beneficial things you can do for your overall well-being!

How I learned to calm my mind with movement:

Through the years, as I have become more aware of listening to my body and provide for its needs, I have learned the importance of handling stress better. I recognize now that when I experience significant amounts of pressure in a short amount of time, not only do I feel exhausted but I also suffer from an increase in symptoms. If I am under stress for a more extended amount of time, I have prolonged symptoms and discomfort. I have developed habits of practicing yoga, going on walks, and meditation- all things that allow me to slow down my mind and put life on pause. However, I do not only do these things when I'm stressed. They bring me such joy and contentment; I make time each day to do at least one (sometimes all) of these activities!

One of the best things about yoga is that it can be done almost anywhere. I love taking advantage of the beautiful weather and fresh air!

One of the best things about yoga is that it can be done almost anywhere. I love taking advantage of the beautiful weather and fresh air!

Typically, I start my morning with at least a ten minute meditation which helps me set my intentions for the day. While I have tried to sit in silence and meditate, my attention span is not that disciplined yet, so I use guided meditations from Headspace. If you're interested in practicing meditation, I would recommend downloading an app or finding videos on YouTube- both great resources! Another thing I do quite often is take what I like to call "Mindful Walks." I put on a podcast or playlist and take a long walk, making sure to be present and aware of my surroundings.

My favorite way to relieve stress is through my yoga practice. When I was younger, my older sister and I used to take classes together, and I have been intrigued ever since. Through the years I have leaned into my yoga practice to help quiet my mind and work on connecting my body and brain. At first, I was intimidated by the idea of flowing on my own. I thought it had to be in complete silence or to mellow music, and surrounded by aromatherapy. I soon realized that the purpose of yoga practice was to embrace my own intentions and make the most out of my time. I don't put pressure on myself to have a perfect session because I'm learning and am allowing my body to move the way it wants. Most of my sessions include aromatherapy, the twinkle lights in my dorm, and one of my favorite playlists. Even if it is only taking five minutes to flow, I notice an extreme shift in my mood after a session- I feel renewed.

 

 

In the past, I would isolate myself and push through the pressure until I would eventually crack and break down. In the moment, I may not feel like moving or pausing but I have to remind myself of how I feel afterwards and the temporary rest I am giving to my body. After I am active, I not only feel more relaxed but I feel happier and come out with a better mindset- more motivated, present focused and ready to take on the next challenge.

Stay Lovely,

Erin

7 Tips For Easing Travel Anxiety

By Erin Dunne

The weather is getting warmer, school is coming to a close and the time for traveling is here! I have been lucky to travel with my family on many road trips and am starting to go off on my own as I get older. I love traveling no matter where I go or who I am with, but I still get apprehensive when planning. Will I be able to eat out? Is there a grocery store nearby? Do I have to take my medication while I'm away? What if I get sick?

Going to new places and being confined in a single mean of transportation can be very stressful and bring out anxiety in people with #IBD. I don't know about you, but being bloated, in pain or uncomfortable is not precisely how I'd like to spend my trip. It's unpleasant enough at home but is even more so when away. Although I have a lot more traveling ahead of me, I have already learned through the years ways to ease my anxiety and make traveling as smooth as possible.

My top IBD friendly traveling tips are:

1. Set up a game plan with your travel buddies:

It's always best to make sure that you and your travel partners are on the same page and at least have a general idea of what you would like to get out of the trip. As someone with gut issues, it's important to clarify any needs that may need to be met while you're away- special diet, bathroom accommodations, etc. Explaining your concerns will not only help your partners understand better but will also put you at ease. By constructing a game plan, you'll have a better idea of what you'll need to prepare for- whether that means packing your own food for certain meals or staying somewhere with multiple bathrooms and a fridge.

2. Research restaurants you can go to:

I'm a BIG foodie so finding the best local places to eat when traveling is extremely important to me. I like to try to stay away from chain restaurants as much as I can when I'm away so I can experience more new places on my trip. By being prepared with gut-friendly places to visit, when the question of "where should we go to dinner?" comes up, you won't have to frantically search for restaurants on your phone while others wait. If you can't find a restaurant menu online, don't hesitate to call and ask if they can accommodate your needs. From experience, most places will be more than happy to work with you to create something you are comfortable having!

3. Stay somewhere with a kitchen:

Eating out for every meal can be expensive, impractical, and not always easy on the gut. With that being said, staying at a place that has a kitchen/ kitchenette can be very helpful and makes it easier to create your own meals. Being able to cook takes out the fear of getting a restaurant induced stomach ache and gives you some control as to what's being put in your body. Before traveling, make sure to search for any nearby grocery stores, so you can pick up some staples and save time.

4. Bring supplements:

Even if you think you can go a few days without supplements, bring them if they help your gut feel better! In my opinion, it's best to be over prepared than under prepared. Making sure you have your medicine and supplements (if you take any) can be stressful. If you're like me, even if you double and triple check that you have packed everything there is still a fear in the back of your mind that you forgot something. Put your medicine and supplements in a place that is both easy to remember and is accessible. I typically put mine in a pill organizer in my carry-on.

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5. Pack snacks/meals:

If you have been in an airport before, you probably know that many of the items are often overpriced ($5 for a bag of trail mix that's mostly air? No, thank you). I always come prepared because it doesn't matter if I am stuck on a long car ride, a plane, or just walking around town- when hunger strikes, I need food asap. By packing some of your favorite, healthy snacks, this takes out the chance of settling for something that might upset your stomach. Some of my favorites are fresh fruit, homemade nut mix, and Larabars!

6. Pack your go-to remedies:

Bring some of your most effective remedies to help with any discomfort that may occur while you're away. Have a reusable water bottle on hand to make sure you are staying hydrated (and maintaining the environment). Some of my go-to's include: Bone Broth, Pedialyte packets, Apple Cider Vinegar, and essential oils. Having these items with me when traveling helps me feel at ease because I know that while I'm at home, they help make me feel better and if I am away, they will do the same.

7. Incorporate parts of your regular routine:

Most trips can follow a jam-packed itinerary that can leave you feeling exhausted by the end of the night and wishing for more sleep the next morning. While this may work for some people, others may function better with a flexible itinerary. Even if away, sticking to part of your daily routine can keep you more grounded and feel more comfortable when thrown into the unfamiliar. My morning and evening routines are very set in stone and help me unwind, so I always make sure to implement some of the same activities into my travels. At home, my routines are much more elaborate, but I make sure to take the simple, yet impactful things with me wherever I go. In the morning, I meditate and drink warm lemon water with Apple Cider Vinegar. Before bed, I drink a cup of tea and read or listen to an audio-book.

 

 

Ultimately, recognizing that traveling is never going to be perfect is the biggest help. Life is unpredictable and the best of us get a headache or stomach aches at what seems like the most inconvenient of times. I know it can feel as though you are high maintenance and you may also feel bad for "inconveniencing" your travel partners, but this is very far from the truth. Know that your health comes first and you deserve to enjoy yourself just as much as anyone else- you just may have to take a few extra steps to make this happen! These steps are necessary, and over time you will become more comfortable with whipping out your pre-packaged meal while your friends have take out. A happy gut leads to a happy traveler!

Stay Lovely,

Erin