Tag Archives: depression

The Mind/Body Connection in Chronic Symptoms

neck pain

Pain and other chronic symptoms—like IBS, vertigo, tinnitus or bladder issues—can take over our lives. Physical symptoms naturally create fear, and symptoms and fear together can become the center of our attention, pushing everything else into the background.

When pain or symptom keep us from doing the things we enjoy, it’s common to feel anxious or depressed. In fact, most people who struggle with chronic pain also experience anxiety or depression. It’s not always clear which came first, because they are closely connected. Many people with chronic symptoms have experienced childhood adversity, and are likely to be perfectionists or people-pleasers—traits that can increase stress and make us more vulnerable to both physical and emotional symptoms.

While chronic pain and other physical symptoms appear to be based in the body, research shows that trauma, emotions and stress play a powerful role—even sometimes when pain seems to have a clear physical cause.

I experienced this firsthand. Years ago, I developed chronic wrist tendinitis that was attributed to  typing too much. My pain was real and constant, and I tried everything—chiropractic, physical therapy, massage, acupuncture, Alexander Technique, and Feldenkrais classes. Nothing helped for long. I had to stop doing many things I loved. I wore wrist splints, used voice-recognition software, and avoided cooking, gardening, and knitting. Despite all these precautions, I was in pain for more than two years.

Then I found Dr. John Sarno’s book Healing Back Pain. He discovered that many people who had  physical findings that might cause pain—like herniated discs or arthritis—had completely different pain experiences. Some had severe pain, while others with the same imaging results felt none at all. One large study of over 3,000 people found that spine changes seen on MRIs are usually a normal part of aging and don’t necessarily cause pain. His work with his patients demonstrated that emotional stress and repressed anger can create very real physical pain. He helped many thousands of people recover from chronic pain with his medical practice and his books. I was one of them. 

It’s important to note that pain or other symptoms are not “all in your head.” Chronic symptoms are  absolutely real. But all our experiences are mediated by the brain, and our brains interpret pain based on not only sensations sent from the body, but also based on expectation, and the perception of danger. If we’re afraid that something is wrong with our bodies, or of conflict, negative emotions, or anything else we experience, pain and other symptoms can begin or intensify. On the other hand, if we feel safe and confident in our body’s strength, and in our ability to handle our emotions and our relationships, they can fade—even when nothing physical has changed. This is why treatments that reduce fear and increase a sense of safety can be so effective. The fact that changes in in how we interpret the world impact our symptoms is why we call these symptoms “neuroplastic.”

Over the past several years, there has been increasing evidence supporting Dr. Sarno’s theory, and new treatments have begun to be proven to help patients overcome neuroplastic symptoms. In 2020, I completed training with the Pain Psychology Center to work with clients using Pain Reprocessing Therapy (PRT). A study at the University of Colorado found that people with long-term back pain experienced major or complete recovery after just four weeks of PRT.

PRT helps retrain the brain to interpret pain signals differently. It uses mindfulness, cognitive, and behavioral techniques to reduce fear, calm the nervous system, and build a sense of safety in the body. As fear decreases, pain often does too—sometimes permanently.

Chronic symptoms, as miserable as they can be, often serve hidden purposes. They may give us permission to slow down, rest, or seek care from others. They may distract us from emotions we’d rather not face. Understanding these patterns can help us reclaim our energy and our lives.

When we start to truly trust that our bodies are strong and resilient, and that we can handle our emotions and the stresses in our lives, we can stop letting pain dictate our choices. With the right tools and mindset, recovery is possible—and life can feel full and joyful again.

 

Take a test to see if your chronic pain or symptoms are likely treatable using a mind-body approach

References:

  1. Sarno, M.D., John E. Healing Back Pain: The Mind-Body Connection. New York, NY: Warner Books, 1991.
  2. Sarno, M.D., John E. The Mindbody Prescription: Healing the Body, Healing the Pain. New York, NY: Warner Books, 1998.
  3. AJNR Am J Neuroradiol. 2015 Apr; 36(4): 811–816.

    Published online 2014 Nov 27. doi: 10.3174/ajnr.A4173

 

Antidepressant Medication in Pregnancy

Pregnant Belly

The debate over the safety of psychotropic medications during pregnancy continues to spark strong opinions. Critics of antidepressants often cite numerous articles and isolated studies highlighting potential risks or questioning their effectiveness. What we’re seeing, in many cases, is a form of “splitting”—the tendency to categorize something as entirely good or entirely bad. When it comes to psychiatric medication, people often fall into one camp or the other and accept only the evidence that supports their viewpoint.

The reality is more nuanced. Yes, some psychiatrists make mistakes, and psychiatric medications can be overprescribed or misprescribed. Some people do not respond well to them. But many others experience profound relief, and for some, these medications are lifesaving. This is why clear, balanced, and evidence-based information about the use of psychotropic medications during pregnancy and breastfeeding is so critically important.

Many who oppose antidepressants advocate for natural or holistic approaches to treating depression and anxiety. These approaches can absolutely be helpful for some people. I’ve personally tried acupuncture, chiropractic care, homeopathy, craniosacral therapy, and herbal treatments, and at times found them beneficial. But, just as we rely on modern medicine for conditions like Type 1 diabetes, there are situations in which holistic measures simply aren’t enough.

In my own experience many years ago, no amount of holistic treatment or psychotherapy touched my severe postpartum anxiety and depression. I was eventually hospitalized when I no longer wanted to live. Six weeks after starting an antidepressant, I was able to function again and finally benefit from therapy. I know that medication saved my life, and I’ve heard countless similar stories from other birthing people.

Perinatal mental health disorders have both biological and psychological components. Hormonal shifts, physical recovery from childbirth or cesarean, and chronic sleep deprivation can all play significant roles. In my work with birthing people, I’ve seen again and again that those with severe perinatal depression, anxiety, or OCD often do best with a combination of approaches—psychotherapy, self-care, social support, nutrition, sunlight, and moderate exercise, and medication when needed.

Some parents choose not to take medication, and many do recover with therapy, support, and lifestyle changes. But some later wish they had considered medication sooner, regretting the weeks or months lost with their baby while they struggled to bond or function due to overwhelming symptoms.

Untreated depression and anxiety during pregnancy and the postpartum period carry real risks. They can affect birth outcomes and have lasting effects on the parent, the baby, and the entire family system.

The truth is that some new parents simply do not have the energy, motivation, or clarity to benefit fully from therapy or self-care until their symptoms are stabilized. In my experience, most of these individuals improve significantly once they receive the right medication. That practical reality matters far more than abstract debates about whether medication is “good” or “bad.”

New parents deserve balanced, compassionate information—not scare tactics, shame, or political agendas. Their health, their babies’ well-being, and their family’s future depend on access to accurate guidance and the full spectrum of effective treatment options.

Perinatal Mental Health and Perfectionism

canstockphoto10868712

You’ve read the books. You’ve prepared the nursery. You’ve heard about Postpartum Depression—even if you may not see yourself as someone who’s likely to experience it. The commonly known risk factors for Perinatal Depression and other perinatal mental health disorders include:

  • A previous episode of depression or anxiety (especially during pregnancy)

  • A recent loss or major stressor, such as financial or health challenges

  • Lack of social support or relationship difficulties

  • A complicated pregnancy or birth, or breastfeeding challenges

Many of the clients I work with can check several of these boxes, and having one or two doesn’t guarantee you’ll struggle emotionally after birth. But there’s another risk factor that’s harder to measure—one that isn’t about what has happened to you, but about how you relate to yourself and the world.

Research shows that perfectionism and related personality traits can significantly increase the risk of postpartum depression. In particular, new parents who struggle the most with making mistakes are about four times more likely to experience postpartum emotional challenges. Also at higher risk are those who naturally prefer order, clarity, and control. This makes intuitive sense. Becoming a parent is the ultimate beginner’s role—messy, unpredictable, and often undertaken on very little sleep. If uncertainty or imperfection has always been hard for you, new parenthood can feel especially overwhelming.

In my practice, many of the new parents who struggle most aren’t just perfectionistic—they’re also used to taking responsibility for everyone else’s feelings and needs. That may work—barely—before a baby arrives. But a newborn instantly multiplies the emotional load. Babies cry. They will cry no matter how devoted, attentive, or skillful you are. And the more pressure you put on yourself to be a flawless parent, the more strained your energy and relationships can become. It’s a setup for stress, anxiety, and depression.

This is why learning to let go of perfection—in small, practical ways—can be powerful preparation for parenthood. Let the dishes wait a few hours. Run out of clean socks once in a while. Burn the rice because you got lost in a great article. Notice what’s going well instead of what could be better. Enjoy the sunshine in your half-landscaped yard. Allow people to be disappointed on occasion—after all, they disappoint you sometimes too. Practicing being good enough is not just healthy; it’s the foundation of sustainable, compassionate parenting.

If the idea of leaving a dish in the sink feels impossible, consider trying mindfulness practices or guided exercises. Mindfulness can help you accept what’s happening in the moment instead of feeling responsible for fixing everything. And you might benefit from support with a warm, understanding therapist (bonus points if their desk is a little messy). Learning to release some of the pressure you’ve carried for years is an investment in your well-being—and in the emotional health of your growing family.

Perinatal Mental Health Disorders

Risk Factors, Symptoms, and What To Do

Take a Screening Test for Perinatal Mental Health Disorders

The Baby Blues has become as much an accepted part of being a new birthing parent as engorged breasts and sleep deprivation. But what if the Blues don’t go away? For 10-20% of new parents, a perinatal mental health disorder (PMHD) is an unwanted and difficult part of the first year of parenthood. The causes of PMHDs are many, and can include hormonal and lifestyle changes, a lack of social support, sleep deprivation, a high-risk pregnancy, a traumatic birth or difficult recovery, or breastfeeding problems. You are also at a higher risk of PMHDs if you have suffered previously from anxiety or depression, or have recent losses or trauma in your life. Symptoms of PMHDs can include:

  • Feeling sad, depressed, numb, or crying a lot
  • Restlessness or irritability
  • Excessive worrying or inability to relax
  • Unusually strong feelings of anger or resentment
  • Lack of energy
  • Having headaches, chest pains, heart palpitations, numbness, tingling, dizziness or nausea, hyperventilation or other unexplained physical symptoms
  • Difficulty sleeping or excessive tiredness
  • Loss of appetite or conversely, overeating and weight gain
  • Difficulty concentrating, remembering, and making decisions, or confusion
  • Excessive concern about the baby or lack of interest in the baby
  • Feelings of guilt and worthlessness
  • Lack of interest or pleasure in activities
  • Obsessive thoughts or compulsive behaviors
  • Fear of hurting the baby or yourself

Many new parents experience only a few of these symptoms, but if you feel like something is wrong and you’re not quite yourself, that is an important signal. If these symptoms persist for two weeks or more, you should promptly get support by talking to your doctor or a mental health professional. PMHDs are highly treatable, with therapy, medication, or a combination of the two.

If you need medication and you are told that you must give up breastfeeding, make sure you get the advice of a prescriber who is knowledgeable about medications for breastfeeding parents. There are a few antidepressants which are routinely prescribed during breastfeeding  with untraceable amounts detectable in the baby’s bloodstream. Moreover, breastfeeding can be beneficial both for the birthing parent, the long-term health of the baby, and bonding, which is even more challenging when a parent is depressed.

Depression not only affects you: it affects your relationships with your partner and your baby. Untreated, depression can lead to bonding difficulties and delayed development or failure to thrive. Getting the help you need to recover quickly is the best thing you can do for your baby and yourself.

Most importantly, tell your support people (your family, friends, partner) how you are feeling. The burden of trying to seem happy and “keeping it all together” can make the depression worse. You need to lean on the people who care about you, get as much help as you need until you’re back to feeling like yourself, and don’t beat yourself up for having a PMHD. It is NOT YOUR FAULT.

Can You Recover from Depression Without Medication?

73a992a88ccf98e0e7334303949b0c17An article I wrote for the GoodTherapy.org blog. The important take-away: depression is a serious illness. Mild to moderate depression often can be treated through psychotherapy and improved relationships and self-care. But if you need medication to recover, it’s still important to get better however you need to.

http://www.goodtherapy.org/blog/can-depression-be-cured-without-medication-1117144

People-Pleasing Moms: At Risk

Sad new mom holding baby - people-pleasing momsOne of the common themes I come across when working with mothers experiencing depression and anxiety is perfectionism and people-pleasing. Moms get worn out when they are trying to make everyone happy all the time.

There are often good reasons for a tendency to be over-responsible for the feelings of others. Many of us come from families where there was an unspoken expectation that a child must be “good,” because one or both parents were unable to tolerate the challenge of even normal childhood misbehavior. Or sometimes, children develop an unconscious habit of caretaking for others as a way to get their own needs met.

Read the Article

Take a test to see if you have Prenatal or Postpartum Depression