If you're living with a chronic illness, you're in the right place.

Monday, November 25, 2013

6 Antidotes for Holiday Stress

Thanksgiving week is here.  The holidays can be considered a stressful time of year for many of us - uncle Pete just loves to talk politics while passing the mashed potatoes or how am I going to find room for my cousin who tends to overstay his welcome?

For those living with chronic medical illnesses, the holidays may mean trying to find the energy to go to Thanksgiving dinner, having to explain to Aunt Bethany why they can't eat the stuffing for the 12th time, or struggle to maintain conversation while experiencing nagging pain. It's enough to send the stress meter off the charts, and we may begin to lose it a little.

Every year we know the holidays are coming, but every year we get stressed out.  That doesn't really make a whole lot of sense, does it?  Holiday stress may be inevitable, but the degree to which it hits us is really up to us.  Here are 6 things you can do to help dial down that holiday stress meter this year:

 1. Let Go of Perfectionism

A lot of our stress is self-inflicted.  We want things to be great, perfect even.  Who doesn't?  It's okay if things aren't.  Do your best and if things don't turn out as you pictured in your mind, it's not a catastrophe (see #2).

2.  Stop Catastrophizing

When things don't go our way, or even don't seem like they're going to go our way, we have this tendency to really blow stuff out of proportion - what we therapists call catastrophizing.  The turkey being a little on the dry side or grandpa making an inappropriate comment isn't the equivalent of a nuclear bomb going off.  And just like holiday problems are nothing like being nuked, where you're pretty much up a creek without a paddle, IF the worst case scenario happens you can handle it.  Remember all the other times you dealt with horrible situations.  Were they unpleasant?  Sure.  Did you just want it to be over with?  Absolutely.  But you're here, and probably wiser because of it.

3.   Don't Discount the Positive

It's so easy to focus on what's wrong with a situation. And in this process, we can ignore what's right.  In almost every situation that feels catastrophically bad, there's an alternative viewpoint that includes something that's good.  I'm not pushing the power of positive thinking; rather, the power of realistic thinking. Remove the negative filter.

4.  Keep Emotional Reasoning in Check

I feel, therefore it must be true.  If I feel like dinner is going horribly and people are having a bad time, or my friend must hate the gift I gave her (see #5), then it must be the case.  When we think with negative emotions, our reality becomes a bit distorted. There may be a significant disconnect between what we feel (and think) is happening and how others see the situation.  

5.  Quit Mind Reading

Like Clark peering into a Christmas tree, we can try to peer into other peoples' minds to guess what they're thinking.  We're not Miss Cleo (too young for that reference?).  This one is tough because there's really no way to be absolutely sure of what others think about us or a situation, so it requires a bit of faith and trust.  Unless you have some real evidence to back up your beliefs, there are 2 options:  let them go or ask the person.

6.  Burn Off Some of that Steam

You might think that the reason there are Turkey Trot 5Ks is to help burn off some of the Thanksgiving calories. Perhaps.  But a better reason is to help burn off stress.  Not ready to run 3.1 miles?  Make time for whatever your favorite stress-relief activity is.  Don't have an activity?  Go for a 20 minute walk.  Think of your favorite vacation spot and picture yourself there for 10 minutes.  Take 10 deep breaths.  Channel your inner Buddha.  Pray.  Write down your frustrations in a notebook for 5 minutes.

These suggestions may not cure holiday stress, but they will help.  I promise.

Dr. T

Sunday, November 17, 2013

'Tis the Season: Thanks. Giving.

7:21 PM Posted by Stephanie Horgan , ,
November is flying by! Tiffany and I have been busy with multiple community events and speaking engagements, and are looking forward to seeing some of you this Tuesday night at Skokie Hospital for all our IBD patients who live on the north shore of Chicago. As the days seem to fly by, Thanksgiving is only 11 days away, and then come the winter holidays. As we take time to reflect on how much we have to be thankful for, I have to so much joy for how much my own health has improved over this year. Less than a year ago, I was inpatient all month with surgery complications, and I am thrilled to be out and about, working, making a difference, and able to be independent.

Tonight I watched a 60 Minutes show where part of it was on The Giving Pledge. I had never heard of it before, and wanted to pass it along. It is a commitment by the world's wealthiest individuals to dedicate the majority of their wealth to philanthropy. The qualification to be in this elite club is to be at least a billionaire, and be willing to donate at least 50% to charity. It looks like the list is up to 115 people, including the well-known Bill and Melinda Gates. I loved this quote from them: "We have been blessed with good fortune beyond our wildest expectations, and we are profoundly grateful. But just as these gifts are great, so we feel a great responsibility to use them well." As a side note, one of the billionaires is the inventor/owner of Spanx, so ladies, the next time you squeeze into a pair, you're giving back.

As we enter the season of counting our blessings and being grateful, I encourage you to brainstorm ways to express your gratitude and give back. There are so many organizations to give to that it can be overwhelming, but if you have a chronic illness, try donating to your national organization to help find a cure. Or find a global cause you are passionate about, like this one in Paraguay, where trash dump workers sift through garbage to make recycled musical instruments for an orchestra for street kids. Before you give, check out Philathropedia to see your organization's financial data, as well as its strengths and areas for improvement.  Happy giving...and please post where you invest so we can join causes!

Friday, November 15, 2013

Does Therapy Really Work?

8:30 AM Posted by Tiffany Taft , , , , , ,
Being a psychologist in the medical world, I'm often met with some skepticism about what I do.  This can come from patients, their families, physicians - you name it.  There is good reason for questioning if psychotherapy is helpful for people living with a chronic medical illness.  Hell, there's good reason to question if psychotherapy is helpful for anyone.  Not because it isn't, but because questioning things is good practice.

Question the evidence...maybe without all the yelling.
The great news is psychotherapy is helpful for a slew of problems, and specific types of therapy are more effective than others.  I personally trained in Cognitive Behavioral Therapy and this is what I use most of the time.  I was also trained in other major approaches - existential/humanistic, psychodynamic, and family systems - which I may borrow from from time to time if it will benefit the person I'm working with.

A popular buzzword in medicine is evidence based treatment.  That is what it sounds like:  is there evidence based in sound, peer-reviewed research to backup the claim that a treatment will help relieve symptoms.  So, is psychotherapy an evidenced based treatment for chronic illness?

Lots of this floating around out there.
The answer is Yes - with an asterisk.  The reason for the caveat is that the research on psychotherapy for chronic illness and what it exactly helps with is evolving, and depending on the research study it may or may not do much.  Such is the nature of clinical research.  There are some swell people out there who like to review a lot of research studies in one area and write a comprehensive review so we don't have to read each study independently, unless you want to.

In the November issue of the journal Inflammatory Bowel Diseases there is such a review article on if psychotherapy is helpful for people with Crohn's Disease and ulcerative colitis.  They looked at 16 studies that used a variety of approaches to treatment and found:

  • Cognitive Behavioral Therapy (CBT) and Psychodynamic (PD) Therapy both help with anxiety and depression related to life with IBD, but did not help as much with physical symptoms or quality of life.  Of the two approaches, CBT was more convincing as an evidence based treatment than PD.
  • Medical hypnotherapy works well to treat physical symptoms and improve quality of life.  There are only a few studies in this area, so the results are positive but preliminary.
  • Stress management interventions (like relaxation training) don't do much on their own for psychological or physical symptoms.
Based on these findings, a combination of CBT and Hypnotherapy would be best for people living with IBD who are looking to feel better emotionally and physically.  Personally, I've used this approach and find it really is helpful for most people.

Got Stress?
Another emerging area of psychotherapy for chronic illness is the use of Mindfulness, a concept that really stems from Eastern religions like Buddhism and was applied to psychology by John Kabat Zinn.  A study in the November issue of the journal Health Psychology found that mindfulness-based stress reduction treatment reduces the stress response in the body, including heart rate, blood pressure, and levels of cortisol (aka the stress hormone) in the body.  This is an important consideration for people living with chronic autoimmune diseases as stress influences how the immune system functions.  This study didn't specifically evaluate the mindfulness intervention in people with chronic illness.

If you're interested in mindfulness, here's a nice resource on the topic with some exercises you can try on your own.

So yes, dear reader, therapy really can help.  The key is using evidence based treatments and recognizing what they do and do not seem to change.

Dr. T

Sunday, November 3, 2013

Sunday Reading List: 11/3

7:45 AM Posted by Tiffany Taft , , ,
Hello, internet people.  Happy Sunday.  I'm sorry about my lack of blogging the past few weeks.  It's been a little crazy, but in a good way, around here.  It's time for another review of some of the latest enlightening healthcare-related news.

The New York Times has a great article about the soaring costs of asthma and allergy medications.  There are a few statistics in this one that might just tick you right off:  The Soaring Cost of a Simple Breath.

A new study finds that healthy people don't need to take vitamin D supplements to help with aging bones.  However, for those who live with autoimmune disorders, vitamin D levels are implicated in their development and symptoms.  So it remains an important discussion point for you and your doctor:  No Sign that Vitamin D Supplements Help Aging Bones.

Ah, Dr. Google.  If you tend to be a worrier, then looking online for medical information may not be the best strategy.  As I've said ad nauseum, the web is a great resource and is chalk full of great information and really really bad information:  Too Much Online Health Info May Worsen Worriers' Anxiety.

If you didn't hear about this one, it stirred up quite a bit of controversy and debate.  A woman outside of Fargo decided she would give notes to kids she deemed "modestly overweight" in lieu of candy on Halloween.  As a psychologist, I know that this type of shame-until-they-change-their-behavior approach doesn't work.  While I appreciate her concerns about childhood obesity, which has tripled in children and adolescents in the last 3 decades, her approach is misguided and kinda mean.  Woman to Give Obese Children Letters, No Candy.

Excuse my French.

Happy Sunday!

Dr. T