For People with Crohn's, Mental Well-Being Is Just as Important as Physical
The impact of Crohn’s disease on a person’s lifestyle can be dramatic. The unpredictability of flare ups, medication reactions, and even bathroom locations puts a strain on the person’s ability to participate in everyday life. It’s challenging to make and keep plans when day-to-day symptoms fluctuate. And since much of the disease is experienced behind closed doors, friends and family don’t fully understand the implications of a flare up.
The full impact of Crohn’s, though, is beyond the physical symptoms. Crohn’s can and will impact a person’s mental and social well-being too. Extend care to these areas to live a fuller life, even as the pain of the disease persist.
Physical Well-Being
The most obvious impact of Crohn’s is physical. But beyond the symptoms of a flare up—fatigue, nausea, diarrhea, abdominal pain, and more—there are other physical impacts that need just as much care.
Lack of Sleep
Crohn’s symptoms can kill a restful night, leading to lost sleep. The impacts of limited sleep over a prolonged period are sever. Immediately, you become unfocused, sluggish, and less astute. You may even cry more, eat more, or struggle to maintain balance.
After just seven nights of little or disturbed sleep, research from the University of Surrey in the United Kingdom indicated our genes can actually change, increasing the risks for heart issues and obesity. Additionally, our immune system is weakened with no sleep, which is the function already suffering with Crohn’s disease.
To help yourself get the best shot at a full night’s sleep, limit technology use about an hour before bed, limit caffeine six hours before bed, and create a cool, dark, quiet, and comfortable sleeping environment.
Skin Irritations
Crohn’s also causes skin irritations that expand the level of suffering beyond the gut.
Skin sores, like the red bumps caused by erythema nodosum, may flare up with Crohn’s symptoms. Treat these with compression socks and elevate the legs. Other sores are caused by psoriasis, a condition that causes red, flakey, and dry skin and is common in Crohn’s patients. To treat these sores, moisturize with fragrance-free ointments, use a humidifier, and avoid coarse fabrics.
Mouth ulcers and canker sours are common, thanks to acids from the intestines that intensify on a flare up. Vitamin supplements, minimizing acid in the diet, and even swishing warm salt water may alleviate symptoms.
Acne, stretch marks, or thinning skin are the unfortunate byproduct of prolonged steroid use in Crohn’s patients. Using topical skin creams may help, though sever conditions should be discussed with a doctor.
Weight Loss
Dramatic weight loss is common in many Crohn’s patients thanks to the inability to properly digest food. In many cases, patients severely limit their eating for fear of more inflammation. Diarrhea and dehydration are common symptoms as the colon is unable to function normally and absorb fluids.
Sever weight loss or being underweight have far reaching physical impacts. Muscles are usually the first to go with quick weight loss, leaving the body weak and unable to process energy efficiently. Crohn’s symptoms like fatigue, headaches, and dizziness may also worsen as your body declines in weight.
Finding proper nutrition is tough. Fibers are difficult to absorb. Fatty foods and dairy are often out. Take out caffeine too and it’s a pretty limited food pallet. But there is hope. Crohn’s patients can regain their weight and strength over time.
Try keeping a daily food diary to track calories and determine if the weight loss is because of a lack of sufficient calories or symptoms of a flare up, like vomiting and diarrhea. While it may be painful, it’s important to maintain calories and nutrition during a flare up to boost the immune system.
Try to replace large meals with small meals every few hours. Increase fluids, especially water, during a flare up to reduce the risk of dehydration and improve the body’s ability to absorb nutrients.
Remember that weight gain will be gradual, so be patient. First the body needs to rebuild muscle, hormones, and cells and then can focus on weight. It’s also important not to binge eat. Dramatic weight gain can be just as harmful as dramatic weight loss.
Mental Well-Being
The often-unspoken result of Crohn’s is a decline in mental well-being. Mental health can have significant impacts on the ability to deal with Crohn’s symptoms as well as the body’s overall ability to recover.
Stress and Anxiety
The anxiety of an accident in public or new medication can lead to prolonged stress. Even worrying about letting others down with missed plans or the fear of missing out on activities can build into an immovable stress that exacerbates symptoms.
Prolonged stress can cause high blood pressure, heart disease, and will weaken the immune system. Stress causes the body to produce cortisol, which suppresses inflammation; after a long period of high levels of cortisol, the blood may become cortisol resistant, limiting your ability to deal with stress in the future.
“Avoiding stress” is a difficult recommendation. Rather, look for ways to mediate stress, such as walking, reading, yoga, meditation, singing, or doing any activity that gives you joy. Most importantly, recognize when you are feeling stressed and think about the cause. Some research suggests just recognizing the stress can help our brain produce endorphins to control the stress.
Depression
Missing out on activities because of Crohn’s is hard. Spending a week in bed as you recover is also challenging on the body. While neither of these cause depression, the ability for hopelessness and negative thoughts to creep in is high. In fact, rates of depression are higher among people with Crohn’s as compared to the general population. (This is often temporary depression, rather than chronic depression.)
To stave off these feelings, practice positive thinking. You are more than your disease. Every flare up is followed by a period of remission and relief. Use humor, when possible, and decide how you want to respond to your disease. Find things to look forward to, large or small. Go to a movie, buy flowers, or simply dress up for a night out.
Most importantly, cut yourself a break. You may have missed that important birthday party, but your friends will understand. There will be another opportunity.
Cognitive Response Decline
Research from United European Gastroenterology (UEG) showed a 10 percent decrease in cognition for people with Crohn’s disease during an active flare up. To give some scope, that decrease in cognition is lower than people with alcohol impairment. Symptoms could manifest in difficulty concentrating, cloudy thoughts, and memory loss.
The researchers believed this impairment may be due to an inflammation of the bowel causing a simultaneous inflammation of the of the hippocampus activity in the brain. The hippocampus is responsible for memory as well as regulating emotions.
While there is not a quick fix for these declines in cognition, consider limiting strenuous mental work during a flare up. Also, be honest with those around you about your inability to concentrate and memory issues. Making others aware can avoid rush judgements and strained social relationships.
Limited Social Interaction
With the physical and mental impacts of Crohn’s, social interaction seems like an insurmountable fete to many sufferers. Take the skin sores and acne. On their own, those issues would make the best of us self-conscious; banded together they can be a real knock to our confidence and wiliness to socialize.
Although social engagements may be the last thing on the mind of a Crohn’s patient, socializing is essential to our well-being. Prolonged isolation, in fact, can increase blood pressure, make the body more vulnerable to infection, and can even put people at risk for Alzheimer’s. Some studies have shown isolation causes hallucinations and an inability to track time.
Find friends who you can confide in and who build social interactions around your unpredictability. Consider finding a local support group for people with chronic illnesses.
References
http://www.huffingtonpost.com/2013/02/26/sleep-deprivation-genes_n_2766341.html
https://www.everydayhealth.com/crohns-disease/living-with/crohns-disease-and-your-skin/
https://www.everydayhealth.com/hs/crohns-disease-treatment-management/worried-weight-loss/
https://adrenalfatiguesolution.com/stress-immune-system/
http://www.bbc.com/future/story/20140514-how-extreme-isolation-warps-minds
