Lifestyle Changes :: Reducing Chronic Pain, Inflammation And Depression

As a mind-body practitioner and psychotherapist in New York City, I love considering the exquisite interplay between the mind and body, especially when clients present with symptoms that can be confusing. Both women and men who seek therapy or consultations frequently report symptoms that seem to point to anxiety or depression such as: fatigue, lethargy, insomnia and sleep disturbances, decreased social activity, lethargy, decreased libido, appetite changes, and anhedonia. The picture, and the treatment plan, is not always immediately clear. As a society, we are quick to prescribe an antidepressant or medication ignoring some easily-remedied or even the root cause of suffering. Psychotherapists, when they are oriented to a mind-body connection are in the perfect position to take a comprehensive and holistic approach to helping clients improve both emotional and physical well being.

What do we know about depression and chronic inflammation? Studies show a link between depression and inflammation that is bi-directional, that is, depression contributes to inflammatory responses in the body and inflammatory processes promote depression. Inflammation is present in a number of disorders and systemic diseases, including: diabetes, metabolic syndrome, cardiovascular disease, rheumatoid arthritis, multiple sclerosis, asthma, chronic pain, and psoriasis. These chronic health conditions also put individuals at an increased risk for depression, according to The American Journal of Psychiatry

What causes inflammation? Inflammation can occur in response to illness, trauma and stress, in addition to less-than-desirable lifestyle habits. Inflammation is the response that you want your body to mount when you have an injury or trauma. It helps the body heal. Chronic inflammation, also known as low-grade or systemic inflammation is like an ever-present flame in your body that leads to serious, cumulative health problems down the road. 

If you struggle with depression and anxiety symptoms, chronic pain, autoimmune disorders or your blood tests such as C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) come back "out of range," it might be time to seriously work towards lowering the heat in the body by making important lifestyle changes. Many of my therapy and coaching clients find that attending to the physical body, in addition to addressing emotional concerns, trauma and relationship struggles leads to a more balanced and thorough approach to feeling better. What follows are some important health concerns linked to chronic inflammation, pain, depression and autoimmune disorders:

  • Periodontal disease 
  • Thyroid disorders
  • Hormone imbalance 
  • Allergies
  • Eczema
  • Psoriasis
  • RA or rheumatoid arthritis
  • Polymyalgia rheumatica
  • Fibromyalgia
  • MS or Multiple Sclerosis
  • Lupus
  • Crohn's disease
  • Diabetes
  • Obesity
  • Autism
  • Heart disease
  • Alzheimer's
  • Atherosclerosis
  • Cortisol (excess)
  • Depression

In addition to helping clients address psychological concerns such as thoughts, patterns and obstacles, I also encourage them to explore and optimize the following: stress management, self-care, exercise and healthy food and lifestyle changes such as: 

  • Lifestyle positives - Proper exercise, sunlight, sleep, blood sugar regulation, dietary changes, proper nutrition, improved gut integrity, meditation, guided imagery, positive social interactions, feelings of love and appreciation, gratitude, positive thoughts, play and hobbies.
  • Lifestyle negatives - Stress, high cortisol, obesity, blood sugar dysregulation, over-exercising, lack of exercise, high sugar intake, foods that trigger autoimmune responses, hormonal imbalance, social isolation, anger, negative emotions and unresolved trauma.

What follows are lifestyle changes and supplements that support healing:

  • Exercise - Yoga, cardiovascular 3x weekly for at least 20 minutes, Pilates, hiking, biking, walking, etc.
  • Anti-inflammatory diet - Eat whole foods, high fiber, and if possible, a plant-based diet which is anti-inflammatory and full of phytonutrients. Reduce or eliminate trans fats, sugars, processed and refined foods. Dr. Weil has sound and simple-to-follow information on his website
  • Vagus nerve - Learn to actively engage your vagus nerve, that's the powerful nerve that promotes nervous system relaxation and lowers inflammation. Do this by practicing meditation and breathing techniques, deep diaphragmatic breathing, yoga, Qigong. Learn more here
  • Probiotics - Take daily to help your digestion and improve the healthy bacteria in your gut which reduces inflammation. 
  • Food allergies - If you suspect food allergies, find out what they are and avoid these foods.
  • Hidden or chronic infections and toxins - These include viruses, bacteria, yeasts or parasites, hidden allergens from food or the environment.
  • Fish Oil - Fish oil supplements contain omega-3 fatty acids, which are vital to good physical and brain health. Eat healthy fats from nuts, avocados, olive oil and omega 3 fats from small fish like herring, sable, sardines and wild salmon. DHA, in particular, has been shown to have anti-inflammatory effects that reduce cytokine levels and promote gut health. 
  • Ginger - Ginger root reduces inflammation and is also commonly used to treat indigestion and nausea. C-reactive protein or CRP, insulin and HbA1c levels can be decreased significantly with regular ginger use.
  • Curcumin or Tumeric - This super root can decrease inflammation in diabetes, heart disease and cancer as well as improve symptoms of metabolic syndrome (pre-diabetes), osteoarthritis and rheumatoid arthritis. Curcumin can also reduce inflammation markers such as CRP and MDA. Curcumin is poorly absorbed when taken on its own, but is boosted by black pepper.
  • Alpha-Lipoic Acid - Alpha-lipoic acid is a fatty acid that reduces inflammation. Studies show that it reduces the inflammation linked to insulin resistance, liver disease, heart disease, cancer and other disorders. 
  • Vitamins - A good vitamin and mineral supplement that includes: vitamin E, selenium, mixed carotenoids, folic acid, magnesium and supplement with vitamin D, vitamin C, Coenzyme Q10 (CoQ10) and calcium for women.
  • Low Dose Naltrexone or LDN - Regular dose Naltrexone (not low dose) is used for heroin addicts, opiate withdrawal and alcoholism. The low dose or ultra low dose version of the same drug made by a compounding pharmacy works differently and has profound applications for pain syndrome, chronic infections and autoimmune conditions. The very short version of how LDN works is as follows: T reg cells ensure that inflammatory chemicals are secreted as needed to heal you when injured, and then they chill. If the switch stays "on" and you continue to crank out cytokines then your body begins attacking everything in its way -- pollen, dust, and then moving on to your thyroid, joints, adrenals and your nervous system which can lead to RA, MS, Hashimoto’s, Graves, Ulcerative Colitis, Crohn’s, Sjogren’s, Lupus, Parkinson's, Asthma and other chronic health concerns. (It's even being used to boost immune function when fighting cancer). Low dose Naltrexone acts as the "boss" and helps regulate your immune system. LDN reduces inflammation in your nervous system too, so if you struggle with Fibromyalgia, Lyme, depression, Chronic Fatigue Syndrome or neuropathic pain. Increased endorphins are one aspect of LDN as it relates to decreasing pain--it's a complicated, yet elegant process, so you may want to really understand it by reading more here...                           

Always check with your doctor first, especially if you have a medical condition or take medication. Some doctors are holistic and practice complementary and alternative (CAM) treatments. In general, it’s best to get your anti-inflammatory nutrients from whole foods. However, in the case of excessive or chronic inflammation, supplements can help bring things back into balance. Psychotherapy and counseling or "talk therapy" can help clients manage emotional concerns, negative thoughts, anxiety and learn to handle the stress in their lives more effectively.