Symptoms of physical and mental health difficulties often co-occur via the gut-brain-axis (because your body is not separate from your mind), and therefore integrative solutions are often required (Greenblatt & Brogan, 2015). So when the gut-brain-axis has been compromised (read Part 1 all about this if you haven’t first), and is causing ill health, it often requires a considered effort to return to a state of wellness. At the end of my talk, an audience member aptly asked me the question, “But how do I actually do this?” This question stayed with me for weeks afterwards with thoughts about how hard it can be to recover your wellness when you’re physically and mentally symptomatic, especially when you don’t have energy, don’t have sufficient time or resources, and have an absence of support. So the following is my considered response to this compelling question.
An Intricate Jigsaw Puzzle
When you encounter chronic physical or psychological difficulties, there are many multifaceted pieces to find on the road back to wellness – much like a jigsaw puzzle. Sometimes you’ll find the right pieces yourself, sometimes you’ll need a hand, and sometimes pieces don’t fit. Sometimes you may want to give up – it seems too hard or you’re too unwell. Sometimes a piece may go missing, or you need a break from looking, or bits you’ve started have to be re-done. Along the way you may feel frustrated, impatient, elated, renewed, empowered, or like you’’ll never get there. Your world view can be forever changed by the experience and new values and boundaries may develop around your health and wellness.
Anyone who has any experience with doing a jigsaw puzzle will know that in order to get anywhere (and not become extremely frustrated and give up) you need to have the picture on the box to guide your process – this is a reference point. In healthcare, this picture is analogous to an evidence base, which also requires a strong therapeutic alliance with the practitioner you work with (e.g, the degree of trust, compassion, and credibility they bring to their work). Everyday in my job, I sit with people who are working out the pieces of their own puzzle, and I am tasked with providing them a robust picture on a box and compassionate guidance. In recent years, more and more of the pieces of the picture I provide have revolved around nutrition, gut health (gut-brain-axis), and lifestyle design, alongside traditional psychological and therapeutic models.
If you have had to work out your own puzzle (or are still working on it) because of chronic illness, this process usually involves a philosophical shift and a journey – it took you time to arrive at this point and it will also take time to learn and apply what’s needed for your recovery. This journey is yours alone and won’t look exactly the same as anyone else’s. Hence, my key points in maintaining or resuming an individuals gut-brain-axis health involve a broad and individually tailored approach. This applies whether you simply want to learn how to stay well or whether you have experienced a health crisis that has required you to sit up and pay attention to your body. If this is you, and you notice a sense of overwhelm or resistance to what this journey might involve, just choose where you want to start and do what you can. It is the journey itself that matters and this requires both knowledge about, “What it takes” and an understanding of, “How to do it”.
“The known is finite, the unknown infinite.”
~ Thomas Huxley
What it Takes
Having attempted to boil everything down simply (I am a minimalist at heart), I fitted onto one slide all the vital components of maintaining or returning to a well functioning gut-brain-axis. In an even further reduced form, my core message is this: Find ways to dampen the stress of modern living on your body and mind, in whatever form these stressors take for you. Of course, having identified these is the easier bit – the devil is in the details.
Seven Thoughts on “How to do it”
1) Some things are in your control
The choices you make (nutrition and lifestyle) have a significant effect on the route your path will take when it comes to your physical and mental health. In this model, you can avoid, treat or lessen symptoms through addressing the excesses and deficiencies you are bombarded with daily, to support your gut-brain-axis. And even more importantly then simply reducing symptoms; you can function optimally, as you were designed to.
2) Find your people
Find your people – a journey can be less arduous and lonely if you have other people for the ride. We need others – good attachments are so powerful that they are found in studies to offset our stress response, reduce the experience of pain, and promote wound healing (Cassidy & Shaver, 1999). There are now many local groups interested in community and wellness – the AHSNZ is one such group who provide social media connection and local events (not to mention an awesome international Symposium coming up later this year). Work with health practitioners that you feel heard by, can trust, and who have a sound philosophy and evidence base that informs their practice (Note: sound evidence is more than randomised control trials alone). Notice who uplifts you in your family and peer group and find those who are likeminded and supportive of your intentions. If you don’t have this important component, connect online and find a suitable tribe that way.
3) Just take one step
Remind yourself that you can only do what you can do – especially when you are unwell. Start small and take one step, whether that step may be deciding to work with a health professional, informing yourself by listening to an educational evidence-based podcast like Revolution Health Radio (Chris Kresser) or ancestrally oriented health podcasts such as The Primal Shift orHarder to Kill Radio. Or read some guiding “how to do it” books like The Ultramind Solution (Hyman, 2008) or A Mind of Your Own (Brogan & Loberg, 2016).
4) Address excesses
Build on each small step with one more – the benefits will accumulate. For the excesses you face, which perpetuate a stress response, it may be cutting down and stopping coffee for a month to observe positive changes to your anxiety, stress, energy and sleep. It could involve committing to a break from alcohol and noticing the effects on your physical and mental health (especially sleep and mood quality). It could be getting a relaxing, pleasurable, and screen-free evening routine to optimise your sleep (e.g., using a website blocking App like this to externally control use of social media). In my house, I often do technology-free Sunday’s. Every time, after the first couple of hours of device-checking withdrawal, I feel fundamentally changed from a state of busy ape-brain to feeling content and more present.
5) Address deficiencies
To deal with the deficiencies that we all face to some extent, start with adding in as much nourishing food and good hydration as possible. Optimal nutrition involves an individually tailored approach as everyone is different, but as a general rule, focus this around food that was recently alive (i.e., not in a packet), seasonal fruits and vegetables (organic where possible), nuts and seeds, and well treated animal products. The macronutrient balance you eat matters to your wellbeing – so having sufficient protein, good quality fats (e.g, olive oil, avocado, coconut oil, animal fats), and complex carbohydrates for you is important to maintain a stable blood sugar, make hormones and neurotransmitters, and support adequate energy production. Research evaluating nutritional interventions as a clinical psychology treatment for psychological difficulties is being produced through the Food & Mood Centre in Australia, led by Dr Felice Jacka. This research is in its infancy; however we know enough to advise that nutritional interventions like that outlined above are low risk, accessible, affordable interventions people can investigate, and that an improved diet is associated with lowered rates of anxiety and depression, and improved brain functioning.
If you have more complex gut health issues to contend with then you will likely require working with a health practitioner (my clients often work with my naturopathic colleague alongside me – the very lovely and skilled Felicity Leahy), and having some tests to rule out commonly overlooked deficiencies like B12, Folate, Iron, and Zinc. You might consider appropriate supplementation to boost any nutrient deficiencies up to optimal levels (e.g., this is particularly the case in adrenal and other hormone dysregulation, gut health issues where absorption is impaired, or if vegan or vegetarian). Nutriceuticals (vitamins and minerals) can be important in mental health treatment, and research supports the specific application of these for different types of psychological concerns like ADHD, stress/anxiety/mood after trauma, and insomnia (check out this trailblazing research via the Mental Health and Nutrition Research Group).
Another deficiency I see regularly in our current time, where we are caught up in the constant treadmill of society, is of people not being present in their own lives. Our minds take us into our past and ahead into the future, so much so that we often struggle to sit in the experience we have now. Thus, it can be revolutionary to discover and practice your own brand of mindfulness. Note that the definition of mindfulness that I subscribe to is not about reaching a zen state, but about being able to be compassionately present with your experience, and to do what it takes in that moment to head towards what is important to you.This can involve focusing on your breathing (which itself can shift you from the stress response into the relaxation response), ‘unhooking’ from thoughts, allowing difficult emotional or physical experiences to come and go, or a formal practice that could involve physical components (e.g., kundalini or yin yoga or mindful time in nature).
6) Shape a new lifestyle philosophy
Chronic physical or mental health problems often require that certain difficult questions be confronted, and these are questions that come up all the time in my practice as people attempt to make sense of their situation and find their way to wellness. Have you ever asked yourself these questions?
- How did I get to be unwell?
- How do I want my relatively short time here to be spent? (e.g., Stats report we spend an average of 50 minutes face-booking per day – that’s a lot of time lost into the mindless abyss: What else could you do with that time?).
- How do I want to treat my body and mind?
- What health behaviours do I want my children to learn from me?
- What really matters to me – what’s the point of all this?
- If I did change my health behaviour – what would motivate that change – e.g., children, finances, relationship, sustainability/ethical values, confronting death or disability? Use these values to leverage your motivation.
7) Avoid perfectionism in the quest for health
Importantly, be aware that your expectations, personality traits, and the drive towards perfectionism in health may also maintain a state of unwellness. Orthorexia Nervosa is not an official diagnosis but has recently been used to describe the experience where someone has fixated on rigid eating and lifestyle rules. This is different to choosing to follow a specific food protocol for a health condition (e.g., gluten-free for coeliac disease) or having a passion for a consistent healthful routine. In the quest for optimal functioning after a period of chronic ill health, while you can continue to strive towards recovery, the mantra of “good enough” may be more health-inducing then aiming for “perfect.” “Perfect” is often obsession or anxiety driven and can perpetuate a stress response in its own right.
Thanks to all the attendees who came out in the wake of the November earthquake to gather with us and converse on all things women’s wellness. Getting to partake in this event with my co-presenters was a huge honour and I look forward to speaking at further events with the team at the AHSNZ – especially the 2017 Symposium in Queenstown October 20-22nd. The topic I am speaking on will be released very soon and involves a focus that I’m very excited about pulling together between now and October