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About Crohn's Disease

Ulcerative Colitis and Your Mental Health

ulcerative colitis (UC) can make life hard to predict. A flare-up of symptoms is stressful and can leave you worn out for days, weeks, or even months. Even in remission, you might get tired a lot or have hard time meeting friends or going to work. It’s easy to see why living with this long-term inflammatory disease can affect your mental health.

There’s no evidence that stress actually causes inflammatory bowel disease (IBD), which includes UC and Crohn’s disease. But stress can definitely bring on a flare-up. And you’re more likely to feel anxious and depressed than your friends without UC. Your chances are even higher if you are a woman. Even rats with IBD in lab studies show signs of mood problems.

But there are steps you can take to lift your mood, even when your symptoms get you down.

UC and Mental Health

It’s tough on the body and mind if you’re sick a lot. It’s important to stay tuned in to your emotional well-being if you have a chronic condition such as UC. Mood issues, especially depression, seem to shorten the time between flares in some people. It can also be hard to stick to your treatment when you feel blue. And you are more likely to have symptoms like diarrhea or stomach cramps if you don’t take your medicine.

Experts aren’t sure what the exact link is between stress, mood, and UC flares. But there are some theories:

Inflammation. Stress causes your body to release inflammatory chemicals called cytokines. These proteins can help the body heal if you are hurt or sick. But if they hang around all the time, experts think they may raise your chances of developing depression and anxiety. One reason may be that inflammation affects serotonin, a chemical messenger mostly made in the intestines that are involved with your mood.

Your gut and brain talk. Some experts think anxiety and depression make your UC symptoms worse, and then your upset gut does the same to your mood.

Gut bacteria. The amount and kind of microbes that live in your intestines, also known as the microbiome or microbiota, can change when you feel stressed. Studies show gut bacteria can affect your emotions, immune system, and pain level.

Medication. Corticosteroids that you might take for UC can change your mood while you take them.

Ways to Feel Better

Breathe. You can trigger the body to relax when you take slow breaths that fill your belly with air. Called diaphragmatic breathing, some research shows that it can reduce anxious and depressed feelings. Here’s how you do it:

  1. Breathe in through your nose for 4 or 5 seconds.
  2. Place your hand on your belly. Only your stomach should expand.
  3. Hold your breath for a couple of seconds.
  4. Breathe out through your mouth for about 6 seconds.
  5. Repeat for 5-15 minutes.

Focus your mind. Some studies found that mindfulness-based meditation, like paying attention to your breath, may:

  • Lessen feelings of anxiety and depression
  • Help you feel less pain

Brain scans show that people who pay attention to the moment tend to hurt less because the pain center in their brain is less active.

Intestinal behavioral therapy. You don’t have to have a mental illness to benefit from this kind of treatment. It’s designed for anyone who wants to deal with the stress around UC.

Ask your doctor about:

  • Cognitive-behavioral therapy (CBT)
  • Gut-directed hypnotherapy
  • Stress-management therapy

Get moving. You probably already know that exercise is good for your mood. Studies show it works just as well as antidepressants for some people. But listen to your body. If you are really active for a long time, it can cause more inflammation and make some IBD symptoms worse. Marathon runners sometimes get diarrhea or intestinal bleeding. That might not be a great activity to do if you have UC.

Try this:

  • Moderate-intensity exercises like walking or yoga
  • High-intensity interval training (HIIT) is also safe for people with IBD
  • Weight training, also called resistance exercise, is another option that may lessen depression symptoms.

Reach out to someone. You might feel better if you talk to a therapist, especially one who’s familiar with UC. You can also meet up with people who know what you are going through. The Crohn’s & Colitis Foundation can help you find a support group in your area.

Antidepressants may help. There is evidence they might boost your spirits and ease the pain of your gut symptoms at the same time. But talk to your UC doctor before trying any mediations for your mood. Some can cause side effects that worsen IBD.

Get enough sleep. You should try to snooze long enough that you aren’t tired during the day. That’s probably somewhere between 7-9 hours for adults. Talk to a specialist if you have trouble getting or staying asleep. Insomnia is linked to depression and higher levels of inflammation.

Go outside. Exercising out in nature may lower anxiety more than sweating it out in the gym. There is also evidence that walking in trees or looking at greenery can help lower stress levels in general.

Give yourself a break. You don’t have to pretend everything is fine. Along with all the other things that help you manage your emotions, experts say you will probably feel better sooner if you sit with your bad feelings for a little while instead of trying to make them go away.

Get a Mental Health Check-Up

Hopefully, your doctor would check in with you about your emotional life during your regular UC visit. But if that doesn’t happen, bring it up if your mood is bothering you or has gotten worse. Talk about it even if you don’t think it amounts to mental illness. Don’t just accept it as “the way things are.”

Symptoms to look out for include:

  • You are sad a lot, hopeless, or feel like nothing matters.
  • You no longer enjoy your hobbies.
  • You can’t concentrate.
  • You sleep too much or too little.
  • Your appetite changes.
  • You are irritated.
  • You can’t stop worrying.

If you’ve had thoughts about death or suicide, get help right away. You can talk to your doctor, a counselor, or call the National Suicide Prevention Lifeline at 800-273-8255.

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About Crohn's Disease

An Invisable Disease

Crohn’s and colitis are considered invisible illnesses because the diseases aren’t visible on the outside. So, while someone may look fine, their intestines may be inflamed and ulcerated, they may be in excruciating pain, and their immune system is essentially attacking itself.

Because Crohn’s and Colitis are invisible disabilities, some passengers may feel that they will be judged by asking a member of staff for help or having to spend time trying to explain their symptoms.

Imagine suffering from debilitating chronic pain. Every step you take causes discomfort, and it’s perpetually at the forefront of your mind. The internal battle you’re fighting takes mental and physical energy and just going through daily tasks can be debilitating. However, those looking at you may have no indication you’re suffering, let alone that you have a chronic disease. You suffer from an invisible illness.

WHAT IS AN INVISIBLE ILLNESS?

An invisible illness is one that does not exhibit externally visible signs or symptoms. Those with invisible illnesses and disabilities may have symptoms such as pain, fatigue, dizziness, weakness, or mental health disorders. Many of these conditions deeply impact the people suffering, but show no obvious signs to an outside observer.

By 2020, the US Department of Health and Human Services estimates that 157 million Americans will be afflicted with a chronic illness and the US Census Bureau estimates 96% of chronic illnesses are invisible. Invisible illnesses disproportionately impact women and many are not yet well understood by health care providers or the general public. This lack of understanding inevitably contributes to feelings of isolation and hopelessness for those suffering from such conditions.

CHALLENGES OF LIVING WITH AN INVISIBLE ILLNESS

In addition to the various symptoms of a chronic and invisible illness, people suffering from these illnesses can also experience frustration, guilt, exhaustion, and embarrassment.

For those diagnosed with an illness at a young age, the common stereotype that younger populations are supposed to be healthy makes it especially difficult. For those diagnosed later in life, many feel guilty they are unable to more actively participate in the lives of their families and be active with their children and grandchildren.

Invisible illnesses impact people in all aspects of their lives, personally and professionally. They can severely impact the ability to routinely work and may lead to social isolation and depression.

COMMON MISCONCEPTIONS

Nearly all of those experiencing an invisible illness have to deal with common misconceptions regarding their condition. Here are just a few of those most frequently dealt with.

  • The way a person looks reflects how they’re feeling physically. Someone may look healthy, but that doesn’t mean they are.
  • Invisible illnesses are ‘all in the person’s head.’ Keeping stress at a minimum may reduce symptoms of a chronic illness, but it doesn’t mean the root cause of the disease is psychological.
  • Resting up will make people feel better. Just as people not suffering from chronic or invisible illness are unable to bank sleep (rest for a long period of time in order to recoup or “make-up” sleep or to expend extra energy), neither are those with chronic illnesses. The same amount of rest leading up to different events, on different days, may not yield the same results, as symptoms ebb and flow, often unpredictably.
  • If a person suffering from a chronic illness is enjoying themselves, they must feel ok. Don’t assume a person who’s enjoying themselves, laughing, and participating in activities is symptom-free. Many people have learned to cope with their symptoms to participate in important events and activities, but that does not mean they are feeling well.
  • Stress reduction techniques are a cure for chronic pain and illness. While these techniques may assist with symptom relief, they are not a cure-all.
  • Being home all day is a dream lifestyle. Being home all day, but in constant pain and suffering from an invisible illness does not make for a dream lifestyle, regardless of location. Many people are often couch-bound or bed-bound due to extreme pain. They also experience boredom, as not being able to actively participate in the world around them can be frustrating and disappointing.
  • Those in chronic pain are ‘drug seekers’. People in chronic pain are often misunderstood and mistreated by the medical community. They get labeled as “drug seekers” in emergency rooms and, as a result, are denied much-needed pain medication.

HOW TO SUPPORT OTHERS WITH INVISIBLE ILLNESSES

If you know someone with an invisible illness, there are several things you can do to support them. It’s important to remember everyone wants to enjoy life and no one wants to be a burden; however, people suffering from chronic and invisible illnesses do appreciate your support and understanding.

  • Accept you are powerless to make them better. Your love and understanding are what they need.
  • Take time to talk to them and learn about their illness. Ask questions about symptoms and treatments, and be patient. The more you learn, the better you’ll be able to understand and show empathy.
  • Be with them when they need it and give them space when they want it. Many chronic illnesses become socially isolating, as people are house-bound or lose companions due to the lack of understanding around invisible illnesses. Being around and access may be one of the best support methods available.
  • Try not to get frustrated. One of the biggest challenges associated with invisible illnesses is you get sick and then you continue to get sick, the cycle does not stop. At times, this may get frustrating to caregivers and it’s important for them to realize it’s normal for people suffering this way to be emotionally needy, distant, angry, or sad.
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About Crohn's Disease

Crohns Disease and bad weather

We know that Crohn’s disease can equal big gastrointestinal problems, but we don’t fully know what causes this condition. Genetics and the environment are thought to play roles, along with your body’s unique response to bacteria in your intestines. Another theory is a possible link between Crohn’s and the weather or climate where you live.

Researchers at Massachusetts General Hospital, who collected information on 175,912 women 15 to 30 years old, found that the incidence of Crohn’s disease increased significantly among those living in more northern latitudes. This was especially true for women in the older age range.

Experts aren’t sure what it is about Crohn’s and weather that could cause more cases up north, but one possible explanation is that there’s less sunlight or UVB radiation exposure in these areas, which in turn means that your body makes less vitamin D and doesn’t get as strong an immunity boost as it does in sunnier climes.

Another theory relates to health issues delineated by geography. “Generally areas farther from the equator are more developed countries, with lower incidences of gastrointestinal infections and parasites,” says Ghassan T. Wahbeh, MD, director of the Inflammatory Bowel Disease Program at Seattle Children’s Hospital and an associate professor of pediatrics and gastroenterology at the University of Washington School of Medicine. The theory is that in warmer areas closer to the equator, exposure to common GI bugs may mean the immune system is better able to fight off Crohn’s, “ in contrast to the unexposed gut immune system in cleaner environments,” he says.

Crohn’s and Weather: Putting the Forecast in Your Favor

Just as there’s no “one size fits all” nutrition plan for managing Crohn’s, there’s no ideal Crohn’s climate or geographic region that can rule out Crohn’s flares for everyone. Visit the online Crohn’s Forum, for example, and you’ll see that people’s experiences vary wildly, with some describing worse symptoms in winter and others saying summer heat causes them problems.

Individual experiences aside, however, there are some important warm weather Crohn’s tips to keep in mind, whether you live in the sun year-round or are planning a vacation escape.

“Staying in warmer climates mandates proper hydration, more so for patients with active disease and symptoms who are at risk of dehydration,” says Dr. Wahbeh. Kidney stones can also be a concern for people with inflammatory bowel disease and another reason to stay on top of your beverage consumption. On average, you should be drinking 80 or more ounces every day to stay hydrated.

Keep in mind that whether you’re experiencing bouts of diarrhea from Crohn’s disease or excessive sweating because of warm or hot weather, you’ll need to drink more water. Fever and vomiting can also contribute to dehydration. Signs to watch out for include dry mouth or mucous membranes, little or no urine or urine that’s dark yellow in color, a lack of tears, sunken eyes, and lethargy. There’s also the risk for coma in very serious cases.

People with an inflammatory bowel disease also have a greater than normal risk for skin cancer, according to Wahbeh. Experts aren’t certain how much of the risk is due to the disease itself and how much can be attributed to the side effects of the medications used to treat it. However, there’s no doubt that you should religiously apply a broad spectrum sunscreen and double up on sun protection by wearing wide-brimmed hats, sunglasses, and even clothing that can block UVA and UVB rays.

Living with Crohn’s disease has its challenges, but taking into account Crohn’s and weather factors, as well as following warm weather Crohn’s tips, living and playing in hot weather is certainly possible and perhaps even more pleasurable.

Wrap up stay safe and warm its going to be along 2021

all the best

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About Crohn's Disease

Still Tired liveing with crohns

When my Crohn’s disease is active, my fatigue can be debilitating. Sometimes I’m forced to stop answering phone calls because I literally don’t have the energy to construct sentences. I don’t allow myself to drive because it doesn’t feel safe. I’m basically unable to do anything except the bare minimum, and when I come out on the other side I feel like I’ve been in the deepest fog.

How can I be so tired?

After experiencing fatigue like this on and off for quite a while, I began to wonder how I could possibly be SO tired. I was ‘sleeping’ ten to twelve hours a night and taking a nap during the day. What more could my body possibly want? I wasn’t working. I wasn’t moving much. In fact, I wasn’t using any more strength than necessary, and yet, it still felt like too much.

Anyone with IBD knows that when you’re sick, it often feels like more than just stool emptying from your bowels. It feels like life is emptying out too.

Fatigue and mental health

I found the fatigue contributed to my anxiety and depression, affecting my mental health too. It seemed like I was trapped in this awful cycle and all I could do is come up for air between episodes.

During that time, I took prescription sleep medication, I worked with a sleep doctor, and underwent multiple normal sleep studies. I even followed suggestions on reducing screen time, creating sleep hygiene and more, but no matter what, I felt exhausted all of the time.

Sleep versus rest

This was when I learned the difference between being asleep, and getting rest. Being in bed, tossing and turning, waking up during the night – they all impact our ability to achieve deep sleep cycles characterized by faster breathing, a faster pulse, and rapid eye movements, or REM. There were times that my body may have been unconscious, but it most certainly wasn’t at rest.

It became clear to me that I had to learn how to dedicate time to conscious rest when I was awake. To be honest, this felt awkward and like something I was embarrassed about. Have you ever sat down to do something like this?

Changes I made

There were three changes I made that over time have significantly impacted my levels of fatigue, and I’d really like to offer them as suggestions to anyone who is struggling.

  1. Scrolling through social media, even while laying in bed, doesn’t count as resting. When you brain is actively thinking about things you want, need, or are missing out on, it impacts your body’s ability to rest. Schedule in some breaks to put your phone down.
  2. Guided imagery and meditation are real things that relax your mind AND your body. I rely on the Calm app, but there are others out there as well which offer you these services right from your phone. Quieting your brain quiets your body in a real, lasting way.
  3. Aromatherapy – certain scents are tied to physical relaxation. Whether you purchase a linen spray, light a candle, burn incense or diffuse essential oils, or take a bath with bubbles or salts or bombs, aromatherapy draws upon the healing powers of the leaves, flowers, stems, bark, roots or petals of plants to stimulate the natural healing action of both your body and your mind.
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