Posted on

Understanding a brain with dementia

How the brain works, a very logical and straightforward article produced by Alzheimer’s Australia, gives a clear and basic introduction to the brain dysfunction involved in dementia and always helps me to picture what is going on inside of the head of someone affected by this disease. The article explains that the brain can be thought of as a factory and that the factory runs at peak efficiency when all the parts are working.

At the front of this factory (the frontal lobes) are the directors. They make plans for the factory and decide on who is going to do what and when. As things get underway they get feedback or other information as to how well things are going and they make judgements on what looks good and what does not look so good. Then they make further decisions, to change that or to keep this, and show their appreciation and annoyance. Planning, organising, judging, decision-making and appreciation therefore take place at the front of the brain.

In the middle of the factory (the parietal association cortex) are the managers. Each manager runs his/her own department. The left side is the talking side: there is a speech department that moves the throat, tongue and lip muscles, a language department that is responsible for finding the words you want and knowing the words’ meaning, a music department, and various other departments. The right side is the picture side, with a motor department that helps you find your way around a building, knows where you are when you are driving a car, puts your arm through the sleeve of your coat, and so on.

The directors pass their plans on to the managers, and the managers make sure the directors’ plans are carried out. In order to do this, directors and managers communicate freely with one another, sending messages back and forth.

At the bottom of the factory (the limbic region, amygdala and basal ganglia) are the workers. They do not know what the directors’ plans are, but they know their job and they do that same job day in, day out. They take care of things like appetite control, the need for water, staying alert and awake or going to sleep, as well as basic emotions, such as turning on tears, making the face red and increasing the pulse rate.

When brain damage occurs, basically someone gets sacked. It can be the director, a manager or a worker, depending on where the damage takes place. Someone can also go on temporary leave of absence – for example, when there is a temporary swelling or loss of blood supply in the brain that is reversed in a short time.

The result of any injury, whether permanent or temporary, is that the efficiency of the factory is reduced. Messages are sent but are not picked up. Directors get annoyed. The managers get tired and the emotional workers get overwrought. Confusion reigns.

Understanding who has been fired and who is still on the job can help in interpreting the behaviour of people living with dementia.

This blog is taken from The Dementia Whisperer: Scenes from the frontline of caring by Agnes B Juhasz.

Posted on

Taking charge of anxiety with an invisible illness

Mental health and coping with anxiety affects everyone, and if you are suffering from an invisible illness it can be even more difficult. It’s #mentalhealthweek so here are some tools for looking after your emotional and mental health when dealing with chronic illness, whether it be IBD, IBS, CFS, ME or other fatigue/auto-immune conditions.

How can we deal with anxiety and invisible illness?

Since many patients feel stress can trigger their symptoms, it is vital to try to get a handle on anxiety. It has been suggested that support for this should be part of Inflammatory Bowel Disease (IBD) patients’ care plans, yet currently only 12 per cent of IBD clinics offer this. Therefore, it is clearly an area where more medical services need to be directed. As I discussed in Chapter 1, initial consultations after being diagnosed can lead to the patient being overwhelmed with information and having a variety of leaflets thrust into their hands about the disease they can only take in later. But where’s the leaflet that tells us how to cope with the associated emotions? The leaflet that gives us ways of not breaking down, and staying strong? The leaflet that offers support groups and websites?

Hopefully the studies I have cited have highlighted the growing link between mental health and IBD. Of course, if you feel you are struggling with anxiety and depression it is vital you speak to your GP urgently. If you have done this and are looking for some self-help suggestions to deal with times of worry and help manage your anxiety, then the guidance below from Sally Baker – a therapist who works specifically with the mind-body connection – may be beneficial. (It is important to be aware at the same time that these tips offer general guidance which cannot replace the individual advice of a medical professional and if you are feeling any new symptoms of anxiety and depression, then it is very important to see your GP.)

Advice from Sally

When Sally works with clients living with chronic ill-health she recognises how having little or no confidence in how one will physically feel from day to day encourages self-doubt and frustration. As you are probably aware, feeling negative about yourself can create a vicious circle of frustration, disappointment and anger. One of the first therapeutic approaches she suggests to break this cycle of negative self-thinking is to encourage patients to gain an enhanced level of self-awareness to highlight the impact those uncomfortable emotions have on them.

She has found one of the most beneficial ways of discovering if a person is prone to negative thoughts about themselves is to explore the kind of things their inner voice says to them. If on reading this your response is, ‘What inner voice? – I don’t have one!’ then that is your inner voice.

Your inner voice runs an almost continuous internal dialogue commenting on everything you do and often makes judgements on how well you do it too. Happening as it does just below conscious awareness, one’s inner voice goes unchecked, and unchallenged, for most of the time.

For many people, especially those living with chronic illness, their inner voice is rarely a source of uplifting encouragement. It is more likely to give an unremitting flow of self-criticism, and negative self-judgements (everything from ‘I hate my body’ to ‘What am I doing wrong?’). Taking the time to become aware of how your inner voice speaks to you can accurately demonstrate to you your own level of self-judgement and self-condemnation. Tuning in, and clearly hearing your inner voice, is the crucial first step to silencing the draining and dispiriting stream of negativity that can hinder moving forward and making positive changes. Sally suggests spending a little quiet time – just a few moments – every day for about a week tuning in to your inner voice, and simply listening and noting down the negative statements. A therapy tool she then uses to resolve those negative, limiting beliefs is called Emotional Freedom Technique (EFT or ‘Tapping’). EFT is an energy therapy that has proved highly effective for revealing true feelings, in this case prompted by one’s negative self-talk.

Once you have a greater awareness of your own negative self-talk you can then apply another of her core therapy tools – called Percussive Suggestion Technique (PSTEC) – to turn-down, or dispel, the emotions attached to the negative beliefs you have about yourself. Turning off negative self-talk is the beginning of a powerful journey which can transform a former inner-critic into your greatest advocate – someone cheering for you instead of undermining you.

This blog is taken from Managing IBD: A balanced guide to inflammatory bowel disease by Jenna Farmer, available as ebook and paperback. For more from Jenna you can follow her blog A Balanced Belly, and for more emotional therapy techniques from Sally Baker check out her book Seven Simple Steps to Stop Emotional Eating.

If you found these tools helpful help us raise awareness of mental health by sharing for #mentalhealthweek

Posted on

10 Ways to Colour Your Pregnancy Journey with Love

Midwife Bridget Sheeran has just released her first adult colouring book for pregnant mums. To help you get the most out of the book we’ve put together these ten top tips for using the book on your pregnancy journey.

  1. Notice and enjoy the touch of the book in activity! The good quality paper, colourful & unique hard cover design. Press the double page images flat in the centre of the page – no need to worry about felt pens seeping through; coffee spills on the cover; children pulling and tearing the cover or pictures of real life birth of other women’s shapes, colour, babies and sizes!
  2. Bridget has made it easy to just go ahead and start. The introduction invites you to consider the book as a handy companion with all the best intentions of a midwife there to put into your bag and to take it anywhere with you on your pregnancy journey.
  3. Look at the posed essential questions at the end of the introduction, and with the wishes of an experienced midwife – go ahead, take the time it takes and find your own answers for this birth. If your ‘brain feels tired’ be inspired by the index at the back explaining each image and take what you need from that, not forgetting to add you own ideas.
  4. Genuine, good intentions from Bridget’s best wishes are there for you from woman to woman, to discover and keep. Turn the pages and indulge with the child-like qualities of learning new things – with colours and fun! This can seriously change your way of engaging with the ‘usual’ approach to childbirth and learning, and bring new skills such as ‘letting go’ and ‘jumping straight in’ – like the beginnings of birth, and positively stepping into the unknown.
  5. Interacting with the images and the positive messages about birth and you, will lead you to discoveries of yourself plus whom is connecting with you right now – today – to help you, as others have been helped before. Busy lives can prevent us from ‘taking stock’ of who we need around us and who we have nearby…use the book to consider what Mother Nature shows us to do, such as to listen within, appreciate who cares and connect with both.
  6. Some days are ‘sloppy-jo’ days for resting and yet there will come a day when you feel great and ready to get up and MOVE – the colouring in of Dancing Mamas the evening before contemplating an exercise class or a walk locally can motivate you take that step, knowing there are friends and fun to be had in this healthy pursuit.
  7. Using the small actions of colouring in – literally at your fingertips, you use what’s called right-brain activity. This benefits you, because not only does it bring a sense of calm to your day, but also it is what Nature herself has prescribed for you – in preparation, as your baby grows and for taking care of yourself while pregnant and for afterwards, mothering the baby.
  8. In your own time, before or during antenatal classes, this book can help you consider your questions through the prompting of Bridget’s words and images. It may make you think differently about what perhaps you can do for yourself in preparation, to use your body well and to get your baby down (and out) however you give birth. You can discover how well designed your body actually is – or find out through specific birth classes what skills you need eg flexibility of your joints or pain coping practices.
  9. Pass on what you notice about yourself and Birth to other children, using this book – have fun conversations about the colouring, nature’s way and your growing family.
  10. Focus on your physical and emotional needs now, and this will help you after the birth, because you will have already found what works for you or what is needed. Your resources do include the people nearest you, and the birth workers (midwives & doulas) to help your birth recovery and for you to become the woman you want to be after the birth.

Buy Preparing for Birth: colouring your pregnancy journey by Bridget Sheeran, and let us know your favourite ways to stay mindful and calm during pregnancy on twitter.

Posted on

A gentle introduction to IBS for IBS Awareness Month

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is an invisible, fluctuating disease and as such it is often difficult for family members, friends, colleagues, health service professionals, welfare insurance administrators and others who encounter people with the disease to understand the suffering of the individual.

People with IBS are often faced with troublesome and sometimes severe physical symptoms that in different ways obstruct or challenge their everyday life. The disease is by its nature potentially shameful. In our modern western society some of our most fundamental bodily functions, like flatulence and defecation, are considered to be private and nothing you would want others to know about. Hence, for many persons with IBS, sharing their illness experience does not come easily.

Among healthcare professionals, knowledge about IBS is quite often insufficient and it is regarded as a low-priority disease. Sometimes IBS patients find that their troubles are dismissed or belittled, for example, in healthcare encounters or by family members. Not being taken seriously – at home or by healthcare professionals – can be a devastating experience which affects self-image. For some people getting the diagnosis is affirming, providing a legitimate passport to the healthcare system. For others, however, being diagnosed means nothing but being a ‘closed-case’, and they feel left with insufficient information, advice and support. They find they have more questions than answers. In the jungle of potential self-management suggestions (available through various websites, blogs and chat forums) about what to eat, when to sleep or how to behave if you get urgent bowel movements and start to panic on the bus, it is easy to get confused. Being on your own, having to figure out how to live the rest of your life with an illness that won’t go away, and a disease for which there is no treatment or clear and certain ‘rules’ to follow but learning to know one’s own body and what works best, is not an easy task.

Literature about IBS has until now tended to be either too medically orientated, complex and difficult for lay people to understand, or to be like a pamphlet, too brief to be useful. Irritable Bowel Syndrome is therefore a very much welcomed contribution for all laypersons – people with IBS, family members, colleagues, neighbours and others who for some reason need to learn more about the disease, what life with IBS is about and what help is out there. The book offers a thorough explanation of the mechanisms and (as far as there is scientific evidence) likely causes of IBS, and of available pharmacological and non-pharmacological treatment options. It also portrays life with the illness from the perspective of those who live with the disease, and linked to this, a variety of self-care strategies are described. The book can of course be read as a whole, but it also forms a very useful reference book for certain aspects or topics of particular interest to the reader. I am certain that anyone who is interested in knowing more, or has specific questions, about IBS will find useful information and answers to their questions.

Cecilia Håkanson RN, PhD is a researcher and senior lecturer at the Palliative Research Centre and the Department of Health Care Sciences at Ersta Sköndal Bräcke University College, Stockholm, Sweden. She is also an affiliated researcher at Karolinska Institutet, Department of Neurobiology, Care Science and Society, in Stockholm, Sweden.

This extract is taken from Irritable Bowel Syndrome: Navigating your way to recovery By Dr Megan Arroll and Professor Christine Dancey

Posted on

Eat to beat depression

Eat to beat depression for World Health Day

Tackling depression naturally for World Health Day

Nutrition-related health issues seem to take an age to become part of accepted medical practice. The medical establishment requires comprehensive scientific evaluation, randomised trials and peer review before a new drug can be licensed, for instance. The pharmaceutical company has to weigh up the costs of research and development versus the potential profit to be made from launching a successful product that can earn a good return on their investment. (When you add in the factor that 80 per cent of their budget goes on marketing, it is clear the stakes are high indeed.) As real food is simply real food and can’t be licensed, branded or patented, there is little impetus for the medical community to fund costly research.

Medical research over the last couple of decades has, nevertheless, highlighted how an unhealthy gut can contribute to many physical diseases and these findings are becoming more accepted in mainstream medicine. Clinicians increasingly agree that the gut-brain axis also plays a crucial part in emotional wellbeing, including the development of conditions as diverse as chronic fatigue syndrome, depression and autism.

The Gut-Brain Axis

The gut-brain axis is a way of describing the interrelationship between gut health and brain health. The various aspects of digestion are controlled via the vagus nerves by a complex set of neurons embedded in the oesophagus, stomach, intestines, colon and rectum. The brain sends messages to all the nerves in your body, including the neurons that control digestion. All work efficiently enough until a person is anxious or stressed on an ongoing basis. You perhaps know for yourself that if you are feeling nervous your stomach can feel upset and queasy. The reason for this is that strong negative emotions, stress and anxiety increase cortisol and adrenaline, which then stimulate the sympathetic nervous system and shut down the parasympathetic system, which includes control of the gut. This causes a physical chain reaction:

* Reduction in pancreatic enzyme production

* Reduction in gall bladder function

* Reduction in the production of stomach acid

* Slowing down of peristalsis – the involuntary muscle movements essential for moving food efficiently through intestines for the absorption of nutrients

* Reduction in blood flow to the intestines

* Suppression of the intestinal immune system

In the short term, this allows the body to focus its resources on ‘fight or flight’ – a good survival mechanism. However, with ongoing stress and anxiety, this cumulative slowing down and suppression of the digestive process can, over a prolonged period, lead to a condition called ‘small intestinal bacterial overgrowth’ (SIBO). As the digestive process is compromised by stress and anxiety, the lack of stomach acid allows the stomach and small intestine – which should both be pretty much microbe free – to be colonised by unhealthy bacteria, and yeasts, causing foods to be fermented rather than digested. In addition to gas and bloating, compromised digestion leads to declining absorption of nutrients, which contributes to the loss of the co-factors needed for good digestion, and consequently further gut problems.

Now consider this situation lasting for extended periods of time. The integrity of the gut lining may be compromised, contributing to gut permeability (‘leaky gut’) that may be sufficient to produce chronic low-grade inflammation.

Chronic Inflammation

The inflammatory process includes the production of cytokines, chemical signals of inflammation that are carried by the blood to the brain. The cytokines can activate cells – so that the inflammation originating in the gut thereby causes widespread inflammation in the rest of the body, including the brain.

The impact of brain inflammation is that the brain has reduced nerve conductance which – guess what – shows up as depression, anxiety and stress.

This vicious circle can self-perpetuate and requires long-term changes to heal the gut, which in turn will help to heal the brain. This is done through changes in behaviour and improving levels of nutrition through changes to food choices. To improve your natural resilience to stress it is important to increase the amount of healthy polyunsaturated omega-3 oils in your diet, so look for oily fish, grass-fed meats and butter made from the milk of grass-fed dairy herds. Good plant sources include hemp seeds, linseeds, chia and some nuts and nut oils (macadamia, almond).

If you consider yourself to be depressed it will be helpful for your recovery to manage your stress levels, improve your sleep patterns and add nutritious and gut-healing foods into your regular eating plan.

Do bear in mind, however, that you may also need professional help if you have been suffering from this debilitating psychological disorder for some time. Please make sure you are accessing all the medical and psychological support you need. Try hard not to add isolation to an already challenging situation.

This blog has been taken from How to Feel Differently About Food by Sally Baker & Liz Hogon.

Posted on

The Science of Stress Hormones

Stress Awareness Month

Exploring the role of hormones for Stress Awareness Month

There are two main hormones governing the stress reaction: cortisol and adrenaline. They work together to exert the ‘fear, fight or flight’ response that was first described in the scientific literature as long as 1936. This response gives a temporary increase in energy production, at the expense of processes that are not required for immediate survival. The resulting biochemical and hormonal imbalances should ideally resolve as soon as the danger is over, due to a hormonally driven negative feedback loop. The following is a typical example of how the stress response is supposed to operate as a survival mechanism:

* An individual is faced with a stressor

* A complex hormonal cascade ensures, and the adrenals secrete cortisol

* Cortisol prepares the body for a fight-or-flight response by flooding it with glucose, supplying an immediate energy source to large muscles

* Cortisol inhibits insulin production in an attempt to prevent glucose from being stored, favouring its immediate use

* Cortisol narrows the arteries whilst adrenaline increases heart rate, increasing the blood pressure and delivering more oxygen rich blood to the tissues

* The individual addresses and resolves the situation

* Hormone levels return to normal

Unfortunately, with our over-stressed, fast paced lifestyle, our bodies are pumping out cortisol almost constantly, which wreaks havoc on our health. In times of high stress the body will break down amino acids to form glucose through the process of gluconeogenesis (a physiological process via which proteins and amino acids are utilised, instead of glucose), to produce energy. Cortisol is the major stress hormone that promotes this process. Collagen, being a structural tissue made from protein, is one of the target areas for spare amino acids; the muscles are another. Chronically elevated stress levels increase collagen breakdown. Since collagen is the matrix upon which our bones are built, anything that is likely to break it down will have potentially serious consequences for the strength and integrity of the bones.

Cortisol primarily acts on the outer layer of the bone, known as the periosteum. Research has shown that elevated cortisol levels interfere with the formation of osteoblasts and cell proliferation. This dramatically decreases bone building and lowers bone density. Without adequate rest and repair, bone mineralisation and collagen formation will be reduced for the duration of the elevated stress.  The absorption of vitamin D is also adversely affected by high cortisol levels. This gives a double whammy in favour of bone loss.

Stress can rot your bones faster than a can of fizzy drink. Stress and the negative emotions that accompany it have been shown to have a chemical structure in our bodies. And guess what? That chemical structure is acidic! With all the emphasis I place on ensuring appropriate intake of alkaline minerals in earlier chapters, and the fact that increased acidity causes increased urinary calcium excretion, is it any wonder that for prevention and reversal of osteoporosis we absolutely have to take stress reduction seriously?

The power of exercise

My favourite way of combating the stress that often accompanies a bad day at work is to get out and go for a run, or go to a karate class. Both are also excellent ways of not only de-stressing the body but also improving bone strength. Exercise is a surefire way to de-fuse. It boosts the level of endorphins in the brain, morphine-like ‘happy hormones’ which are often depleted by our daily lives. Relaxation classes and guided meditation are well worth doing, as is a meditation based on love and compassion. Thoughts of love and compassion stimulate the production of a hormone called oxytocin, whose effects in the body work in the opposite way to those of cortisol. Oxytocin lowers the blood pressure and relaxes the walls of the arteries.

This blog is taken from Love Your Bones: The essential guide to ending osteoporosis and building a healthy skeleton by Max Tuck.