Chances are you have heard of the phrase “stress eating.” You probably know of the comforting effects of “Comfort Foods” such as sugary and high fat foods as well. So, indeed, when you feel stressed out, certain stress hormones produce higher than normal levels in the body. In the short term this surge of stress hormones actually suppresses the appetite. This is also know as the fight or flight response. This is when you don’t feel hunger in the middle of a crisis. This is when the brain sends messages to the adrenal glands to pump out the hormone known as adrenaline, a revved-up physiological state that temporarily puts eating on hold. But when you are chronically feeling stressed, it is a different story. Then the adrenal glands release another hormone called cortisol, and cortisol increases appetite and may also ram pup motivation in general, including the motivation to eat. So if the stress doesn’t go away or if you don’t know of ways to reduce your bad feelings and your stress response stays stuck in the “on” position, cortisol may stay elevated. High Cortisol level also has been shown to increase the intake of high fat and high sugary foods. Once high sugary or high fat food is taken, they do reduce the activity in the parts of the brain that produce and process stress, in other words these “comfort foods” really are comforting!!! That is perhaps another reason why people who report having high stress levels crave comfort food, they actually crave not having stress!!

What to do:

1. Psychotherapy – When you notice that your eating is because of feeling bad not because of the need to eat, then asking the help of a psychologist who is familiar with this pattern can be a life savor. They can help you learn what your stress triggers are and they can help you develop skills to get rid of those triggers, hence your emotional eating will decrease by itself.
2. Social Support – Receiving support from a support group, friends, family and even social media can have a buffering affect on the stress that people experience.

I am Dr. Katie Dashtban and I specialize in Medical Psychology, where people’s physical and mental health have both been affected by one another. Let me know how I can help you or someone you know. Go to www.medicalpsychologyservice.com or www.gettingpastpain.com. Call 831-621-1150 or 408-458-8222.

When it comes to successful management of chronic back pain, sometimes extreme measures such as surgery on the spinal cord is necessary. In this type of surgery a device is used to exert pulsed electrical signals to the spinal cord to control chronic pain.

Often patients are asked to obtain a psychological evaluation before the surgery can be offered. The purpose of the psychological evaluation is to assure that patients’ mental and emotional health as well as their beliefs regarding successful pain management are predictive of successful outcome after surgery. In other words, surgeons and often insurers would like to offer the surgery to candidates that seem likely to highly benefit from it, otherwise the risks may outweigh the benefits.

For more information on psychological evaluation for SCS visit http://www.medicalpsychologyservice.com

When it comes to chronic pain, the matter has clearly been bothering you for a while. You have been coping with pain for at least 6 months, sometimes even years. It is very likely that you feel sad, anxious and maybe even angry for the disruption that pain has brought into your life.

At this point, it might look like it is somebody’s fault that this is not going away. You might be blaming your physicians for not having had successfully been able to cure the pain, or maybe even blame your family members and loved ones for not doing anything to help you, or because of not showing an understanding or empathy about your problem. You may even find the society and your job to blame for causing the situation that put you in pain in the first place, and for not making it easier for you to seek help.

It is tempting to feel that others are to blame for the pain and that it is their responsibility for taking it away. People often put their lives on hold while they are waiting for doctors, family members, even society at large to do something.

There is one major problem with this way of thinking and that is it only prolongs your sense of powerlessness. It makes you feel out of control and at the mercy of others. It sometimes even leads to distortions in thoughts such as: “nobody cares how much I am hurting, or no one can do anything for me, I am all alone in this.”

It turns out that when you take ownership of your own pain , suddenly this feeling of powerlessness can turn into a feeling of being in power, being in charge of things. But now you might be thinking: so I’m responsible for my pain, I am the one to blame? And that is precisely what Is not being implied by taking up ownership of your pain. As you know, self blame, guilt and anger can be paralyzing emotions, they can make you feel so out of sorts, so hopeless that there would seem to be no point in doing anything at all. Taking ownership of your pain means acknowledging that you are a worthwhile person, that there is a point in doing something, and that you do have choices. It is very different than blaming yourself.

By taking ownership of the pain, you get to be the captain of the ship, the one that makes all the decisions about your lifestyle, how much and what kind, you are the boss of your body and in charge of your health.

For more information on managing chronic pain successfully, write or call me at www.medicalpsychologyservice.com or 831-621-1150.

Have a blissful moment.

Metabolic syndrome nearly affects 50 million people in America. Anyone with 3 or more of the following attributes is most likely affected by metabolic syndrome:

• Women: waist size of 35 inches or more, men: waist size of 40 or more.
• Blood pressure of 130/85 mm Hg or higher.
• Good cholesterol (HDL) of less than 40 mg/dL in men, and less than 50 mg/dL in women.
• High fat in the blood – triglycerides of 150 mg/dL or higher.
• High blood sugar, a fasting level of 100 mg/dL or higher.

People with mental illnesses such as bipolar disorder or clinical depression are especially vulnerable. This vulnerability is partially due to medications prescribed for the treatment of mental illnesses, but it is also because of smoking, inadequate nutrition, lack of exercise, and limited access to quality health care. Most people with mood disorders such as depression and bipolarism report that it is difficult for them to get going with exercise, to stay quite from smoking, or to not eat comfort foods such as sugary and starchy foods. Such health habits lead to weight gain, which in turn can domino into insulin resistance, – a condition in which the body cannot use insulin (the main hormone that enables cells to convert blood sugar into energy). As insulin resistance gets worse over time, it takes a toll on the pancreas which then leads to chronically high blood sugar levels. That can cause diabetes which is one of the main risk factors of heart disease.

What to do?

3 ways to keep metabolic syndrome worsening to heart disease.

1. If you’ve been prescribed antipsychotic medications, ask your doctor to give you antipsychotic medications that are least likely to increase risk of metabolic syndrome such as Geodon or Abilify.
2. Monitor the risk factors such as your weight, waist circumference, blood sugar, cholesterol and triglyceride levels, and blood pressure. You can do some of this on your own such as weighing yourself on a scale at home once a week, using a tape measure and a piece of paper to log your waist circumference on it once a month. You can also buy an over the counter blood pressure machine, and maybe even a diabetes kit which is aimed to measure the blood sugars. For the cholesterol and triglyceride levels you’d need your doctor’s help, ask them to help you monitor those by writing a lab order and having those levels checked twice a year.
3. In terms of eating nutritious food, taking up exercising and quitting smoking, you can either use a variety of self help materials such as books, tapes, gyms, a good friend etc. For some people, going to a health psychologist proves to be an amazing investment because often underlying emotions, unaddressed needs, and insight into how to advocate for your own health is needed to secure success in maintaining these health habits.

I am Dr. Dashtban. Write to me with your questions about health and habits to [email protected]

Most people are familiar with the pain scale. It is a subjective way of measuring one’s pain level at a given moment. There is no medical device or medical test that can objectively measure one’s pain level and so health care providers rely on the patients’ own report. The pain scale asks patients to rate their pain level somewhere between 0 (no pain at all) to 10 (the worst pain you can imagine). But it is not unusual for patients to feel frustrated when asked to rate their pain level on this scale. Patients sometimes report numbers higher than 10 on a scale that has a maximum level of 10. Why is that?

It turns out that pain is often anxiety provoking and sometimes down-right scary. Even most health specialists, when faced with high levels of pain, wonder if the pain will ever go away and if they will ever be all right again. The fear of staying in that much pain, the fear of body parts being damaged or at least loss of function at that part can begin to feel so real and so threatening. So when asked by health care providers what their number on the pain scale is, patients are reporting their fear number as well as their actual pain number, and that leaves little wonder as to why a maximum of 10 is not enough to capture what their true experience is.

There is no magical way to foresee what exact message pain has. While translating the exact message of pain can be tricky, pain should be taken seriously because it is always the body’s way of saying something to us. It is perhaps most helpful to trust that once medical work ups have been done and a “no threat” bill of health has been issued by the treating physician, then the fear level be tested separately from the pain level. The fear level often stems from catastrophic thoughts, images of being disabled, seriously harmed. While being on the lookout and perhaps a bit pessimistic can sometimes save future disasters, but often such thoughts prove to be debilitating. At times like this a bit of reality check can save a lot and be very useful.

Ask yourself questions like:

1. Am I fearful of my pain because it resembles the pain of a relative or friend which ended up being disastrous?
2. Are my treating physicians concerned that the higher my pain the more damage I am receiving which will lead to further disability?
3. As difficult it is to deal with it, am I actually going to die from this pain?
4. Can I just concentrate on this hour and not think of how I am going to live the rest of my life?

So, what is your fear number?

Call or write to me at 831-621-1150 or [email protected]