Is it all in our heads? How mental and physical health interact.

Have you ever been in a situation where you started to feel physical symptoms in your body in response to stress? We all have. It’s pretty common actually. Think about the last time you were stuck in rush hour traffic. Did you notice your shoulders were getting closer to your ears? Or your neck got sore? Or your stomach got upset? Physical symptoms that our body develops in response to stressors are called somatic symptoms.  

There are strong interactions between our mental and physical health. Changes in physical health can impact our mental or emotional health. Think about the last time you had a cold, or had an injury and were in pain, your mood probably felt a bit down right? It is also very common to experience sadness, stress, and worry after receiving a major health diagnosis like cancer. The opposite also happens where changes in our emotional health impact our physical health. Stress, anxiety, and depression can increase the risk of heart disease and stroke for example. Stress also changes our immune functioning and can make us more prone to catching a cold or flu.  

Like I said these somatic symptoms are really common. We all have them from time to time. Other common examples are stress headaches, stomach upset when public speaking, or hands trembling when you are nervous. These are normal signals that our body sends us to tell us we are under stress or pressure.

Some people are more prone to developing somatic symptoms and experience them more often, or experience more severe symptoms. For example somatic symptoms can include convulsions, blindness, paralysis, abnormal walking, or severe tremors.

Significant somatic symptoms that interfere with our daily lives are also very common. Up to 40% of individuals who come to a neurology clinic have somatic symptoms (often referred to as functional neurological disorders).

Rather than these symptoms being due to a physiologically based medical condition (like epilepsy, or a movement disorder), they are psychologically produced. This does not mean these symptoms “aren’t real” or are “all in your head”. Rather we generally think of these symptoms as the body’s learned response to coping with stress.

For example one type of personality that is prone to developing somatic symptoms are individuals who are described by others as “the go-to person” in the family, or “the one we can all count on”, or “the one that keeps the rest of us sane”. While this can be a very admirable trait, helping others, often what happens when we are the caretaker in the family is we take on all of the stress and worry of those around us. That stress can be internalized or pushed down deep inside. This can work for a while, and can help us be very successful in some situations. We are able to push through hard times by ignoring the stress. However, they body can only take this for so long. Eventually the body send up the white flag, says enough is enough, and develops physical symptoms.

Another way that our brain learns to be prone to developing physical symptoms in response to stress is through our early experiences. For instance sometimes we are taught when we are young that mental health (e.g. stress, worry, sadness) are not appropriate topics, but physical symptoms are okay to experience. These individuals learn that physical health concerns are acceptable, but stress is not, and so their brains are more likely to develop somatic symptoms.

A third common pattern occurs where there is some triggering event for the development of somatic symptoms. For example someone might have an acute episode of dizziness (maybe due to an ear infection or other illness) but when the reason for the initial symptoms resolves, the dizziness persists. Individuals prone to somatic symptoms tend to be more alert for physical symptoms. Therefore rather than the brain becoming less concerned with these symptoms over time as whatever caused the initial symptoms resolves, individuals become more focused on symptoms and begin avoiding situations that make their symptoms worse. This results in the brain having reduced tolerance for symptoms and symptoms get worse rather than better. Think about this example. Say my dizziness gets worse when I’m in a bright room. So I start avoiding bright lights. Then my eyes get more sensitive to light, and my brain has less strength to tolerate bright lights. Therefore each time I go into a bright room my symptoms get worse, and I avoid lights more. Even though my brain is trying to protect me by avoiding lights, this avoidance is actually making my brain weaker and my symptoms worse.

The good news is that we can build our mental strength to help overcome physical symptoms. I have talked about people who are more prone to somatic symptoms, but there are also people who have remarkable tolerance for physical symptoms. Athletes are a great example. My favorite example of this mental strength to overcome physical symptoms comes from the 1996 Olympics. An American gymnast named Kerri Strug was the last up for her team on an event called vault where the gymnast runs down a runway, flips over an apparatus like a sawhorse (the vault), then lands on the other side. Kerri Strug landed her first attempt somewhat crooked and hurt her ankle. We learned later that she actually broke her ankle in this first attempt. But she needed to finish her second attempt to win gold for the American team. She was able to run down the runway, flip over the vault, and land essentially on one leg to win gold before collapsing. Marathon runners are another great example. They are able to push themselves past what should be physically possible to complete the race, before collapsing just past the finish line when their bodies give out.

Athletes build this mental strength and resilience through practice. Just like learning any new habit, it takes a lot of practice, repetition, and hard work to change our brain’s learned behaviours. Psychologists are great resources to learn how to implement some of these strategies in daily life. Check out the Canadian Psychological Association website for some great resources regarding the role of psychologists.