Allay Group Session: Managing Stress & Anxiety while Living with IBD and IBS
🎙 Overview
In this group session, we invited Natalie Kelly, an ulcerative colitis patient and certified mindset and life coach, who works specifically with folks who have chronic GI illnesses. In this session, we talked about what the stress cycle is and how it can create inflammation. We also discussed as IBD and IBS patients, how we can close the stress cycle while managing our stress and anxiety in the long term.
👤 Who is the host?
Natalie Kelley is a certified mindset and life coach working with folks with chronic illnesses. Her expertise is helping them create mental resilience, rediscover confidence and navigate the mental side of living with one or more chronic illnesses or persistent undiagnosed chronic symptoms.
💡 What is Stress Cycle
The stress cycle is a feedback loop where a queue starts by a trigger that causes stress, during which stress hormones spike. To close the cycle, human body calms down once the stress hormones are used up through movements or other means.
There are two kinds of stress: 1) situational stress and 2) psychological stress. The former appears when people are tangibly engaging in stressful moments, such as running away from a dog that’s chasing them or almost getting into a car accident, while the latter appears when people experience stressful scenarios in their heads.
In modern days, it’s quite common we are constantly facing a large amount of psychological stress from a variety of sources including our chronic GI conditions. More importantly, it’s not always easy to find ways to alleviate some of them, making it easier to form the stress cycle. Nat went on to share a few ways proven to help.
💪 Ways to Close the Stress Cycle
Movement
Exercise is a great way to close the cycle of stress relief. Instead of seeing it as exercise, try to think of it as joyful movement that could help move hormones through your body.
If you want to add movement or exercise into your stress-relieving routine, it’s important to think about how to ensure that it’s not causing more stress. For patients during menstruation, cycle syncing plays an important role – make sure to slow down movements and listen to your bodies. Natalie suggested choosing certain days of the week as rest days, on which no exercise routine should be done. Finally, tune in and see how you feel during and after a workout. Take it slow and recognize that whether you’re doing a 10-minute yoga or an hour, it’s still going to help and benefit your body.
Creativity
Another great way to close the cycle is creativity. Doing things such as painting, knitting, or even singing could be amazing ways to help close the stress cycle. Being creative could be a great solution when you’re noticing a fight-or-flight response from psychological stress.
Crying
Crying can help move stress hormones through the body very efficiently. By using up the stress hormones, it is another effective way to close the stress cycle.
Breathing
Focusing on your breathing and doing breath work are amazing ways to decrease stress in the moment. It lowers the fight-or-flight tendency and calms down the stress hormones. Natalie suggested doing a box breathe, which is the four counts in, four counts hold, and four counts out breathing style. Breathing is not only a great way to get our mind off of what is stressing us out, but also a great way in getting our body back into that lowered stress state and helping our nervous system regulate.
Safe Affection
Hugging and cuddling with someone you trust are great ways to close the stress cycle. It helps regulate our nervous system and get out of fight-or-flight.
Positive Social Interaction
Talking to a friend, having a positive interaction with a stranger or hanging out with someone who makes you feel good inside are all great ways to lower stress in the moment.
🗓 Managing Stress for the Long Term
In addition to breaking the stress cycle, being able to manage stress and anxiety in the long term is hugely important for IBD and IBS patients because chronic stress can be a trigger of symptoms. Here are some tips and reminders Nat mentioned during the session.
Proactive Rest vs Patch-Work Rest
Instead of waiting until you are fully burnt out by stress, you should rest and perform self-care proactively. You can try start taking small steps proactively by making commitment to yourself - start with light journaling, meditation, moving the body or taking a bath. Gradually, you will have more tools available when you want to take rest proactively.
Reflective Weekly “Planner”
Another way to manage stress for the long term is keeping a reflective weekly “planner”. At the end of each day, reflect on:
Where was my stress at?
What were the things that really stressed me out today?
Why did those stress me out?
How could I have handled them differently?
And could I have put up some boundaries to take more time to reflect?
Managing “Shoulds“
When you feel you have a lot of things you should do and are overwhelmed, remind yourself that your bodies are not always up to doing everything that you feel like you should do. You can write them all down and rank them by their consequences. In this way, you can prioritize things that need your attention the most and do them better while keeping your stress under control.
Allow Others to Help you
A big reason for people being stressed is that they try to do it all on their own. When you have IBD and IBS, you need help and support, whether from caregivers, partners, neighbors, friends, or whoever you know. It’s okay to admit that you can’t do it all.
Therapy + Medication
There should be no shame around when it comes to medication and therapy. Taking the right medication could be huge help because it gives you enough relief to have the mental capacity to do other things, such as self-care, reflecting on yourself, and moving the body. The same logic applies to therapy as well. Having someone who is unbiased to be there to support you every week or every other week through life stressors or chronic illnesses could be extremely helpful.
✍️ Q & A
At the end of the session, Nat answered questions from participants live. The following are the transcripts of the questions and answers.
Q: How should I maintain a balance between following health routines and engaging social connections with others?
Nat: We can find ourselves in a moment of being stubborn and wanting to be perfect in the pursuit of the routine, meanwhile we know that it should be a little flexible in order to allow for changes in routine for social interactions. But there are also times when it is okay to advocate for ourselves. It might be helpful to mention that consistency can sometimes be overrated. We need to leave room for listening to our bodies and listening to how our needs change day in and day out, whether socially or physically. Try to have a toolbox of what you know works for you and try to incorporate that into the schedule – even if it does not look the same way every day. Knowing that if there are a couple of days where you don’t do them, you won’t have to fall off the wagon and start over again. It doesn’t mean that our routines are any less effective by being flexible within.
Q: How long would it take to get comfortable with keeping a routine?
Nat: There is a fine balance between keeping a healthy routine and getting addicted to it. I remember going hard every day all the time when I first got diagnosed with Crohn's in 2017. I got to a point where I was almost too strict on following my diet, exercise, and medication routine. That was when a discipline started to cause too much stress. It takes time to find what feels good to us and where we want to do it. Because if it feels like a chore, we might have to recognize that routines are just not for us. There's nothing to be ashamed of and maybe we just need to try something else. It took me a couple of years to find the right method and formula that work for myself I actually enjoy enough to want to keep doing it.
Q: What should I do if finding a public restroom is causing stress and anxiety?
Nat: For someone with IBS or IBD, finding a restroom to use when we are outside could cause a lot of stress. It would be helpful to plan ahead of time. When we get to a new place and socialize, check if the place has a restroom. Are you out in nature? Do you have portable heating pad? Do you have emergency meds? Do you have nausea pills? Taking precautions ahead of time could lower the stress level so that we feel more secure and confident.
Q: What should I do if I feel stressful every time a person tells me that I don’t look sick, then I have to explain my condition, which would remind myself about all the horrible things I had to go through?
Nat: It’s important to remind ourselves that how we look on the outside doesn’t always reflect how we look on the inside. You don’t owe anyone an explanation! Pause and ask yourself: does this person need a full explanation or can I just laugh it off? Let them think what they think. If someone close to us is questioning my illness because how we look, and we value their opinions a lot, we could have a conversation and know it’s worth to do it. Pick your battles and think whether this person worth the energy to explain it.
Q: Being a long-distance runner, IBD diagnosis may have taken away a very big part of your life. How did you cope with this loss of identity?
Nat: When we value a part of our identity so much, no matter whether it is exercising, socializing, or enjoying other things, it could cause a great sense of loss when we have to give it up to our disease our diagnosis, even just a part of it. When I was hospitalized, she wasn’t allowed to work out and had to gain weight. It catapulted me in to an exploration of “who I actually am” because I had spent so many years of my life focusing on movements and exercise. It gave me an opportunity to think about “who am I underneath?” It was a hard process but I feel so grateful. Now, I love self-care, living slowly and all the other things I would have never known about myself if I still clung onto that identity. Remind yourself that maybe there is a version of yourself out there that you haven’t even met yet, and see the diagnosis an opportunity to explore that version. Although it might be hard to lose your identity before your diagnosis, there may be a different version of yourself you know you can grow into and love.
Q: How do you stay proactive and consistent with a routine without letting it overburden yourself?
Nat: Have a whole toolbox of what self-care is. Instead of planning out a strict routine to follow, be in the moment and feel what we like to do for the day. Let your intuition guide you, instead of planning it. Have self-care as a foundation or natural part of daily life, it’s about small things adding up.
Q: How should I cope with reactions to our disease from a loved one or close friend?
Nat: It could be an emotional battle when it comes to people-pleasing tendencies. On the one hand, we want to make loved ones feel special by socializing them and being supportive. On the other hand, it is important to remind ourself that how someone reacts to our illness and the boundaries we put up to honor the body is a reflection on them, not us. It is so easy for our minds to create those scenarios about how our friends are going to react, or anticipate something really bad could happen, but a lot of the times they won’t have bad reactions. It’s a big thing to be gentle with ourselves while working on stress when there is going to be stressful moments.