Stress: It’s Not in Your Head, it’s in Your Nervous System

Traumatic Memory and How to Heal it

Have you ever been told when you’re stressed to stop worrying and just relax? That it’s all in your head? It would be nice if it were that simple. But it’s not.

Physiology research shows that the stress response memory lives in your nervous system. Take for example exposure to a stressful event. One in which you felt helpless, hopeless, and lacked control. In this case your autonomic nervous system (ANS) is engaged. This is the part of the nervous system responsible for controlling unconscious bodily actions like breathing. To be more specific, it was the sympathetic branch (fight or flight) of the ANS that kicked in while you were strained. In addition, the hypothalamic-pituitary-adrenal axis of the midbrain began firing. In which a signal from your hypothalamus sends a hormonal message to your pituitary gland that stimulates to your adrenal glands.

To activate this fight or flight response, stress hormones like cortisol and adrenaline are released from your adrenal glands. They help our body suddenly mobilize to flee danger. According to Peter A. Levine, trauma expert in the field of psychotherapy, trauma occurs when this biological process is overwhelmed and a person is unable to release and process the stressful event. It is possible to avoid a traumatic response by discharging the energy generated. For example, shaking, crying, and screaming can allow the individual to physically process the stress.

Stress is not all in your head.

However, if the stress response is not processed, it remains in the tissues of the body. When a subsequent stressful event that does not pose a serious threat occurs, the traumatic memory is recalled. A large amount of stress hormones are released. Blood rushes to extremities, pupils dilate, muscle tone increases presenting as tension, breathing rate increases, the heartbeats faster, and sweating occurs. Hence, the nervous system responds as if this small incident is life threatening.

This biological response is clearly beyond the ability to rationally control. You can’t think your way out of it. Chronic stress leads to dissociation or immobility, a state of sympathetic charge and hormonal release, which is health damaging. The brainstem (the primitive part of the brain) governs emotional experience and biological response. When the brainstem is activated by the fight or flight response, it trumps the more developed front of the brain, the prefrontal cortex. It is therefore not possible to be in the primitive state of fight or flight and also to think rationally and critically (as the prefrontal cortex would have us do).

Levine elaborates:

The question is: how can humans become unstuck from immobility? Moving out of this frozen state can be a fiercely energetic experience. Without a rational brain animals don’t give it a second thought, they just do it. When humans begin to move out of the immobility response, however, we are often frightened by the intensity of our own energy and latent aggression, and we brace ourselves against the power of the sensations. This bracing prevents complete discharge of energy necessary to restore normal functioning.

Unprocessed stress is stored in the body as traumatic memory.

Unprocessed stress becomes traumatic memory that lies dormant in the body. A present day trigger can cause the stored memory to resurface. Understanding what is happening inside our body and brain, gives us compassion. Learning why our body responds the way it does, leads to awareness and empowerment. It moves us out of being isolated, fearful, victims. By caring for our bodies and understanding their self-protective responses, we can release shame.

When we comprehend the physiologic process that is trying to keep us safe, from an old memory or trauma, we can replace inner judgement with kindness. Self-love becomes possible. It may not be serving us in the present but in the past it did. In fact, this same response helped us survive.

The work is then to re-train the body. This can be done by invoking practices such as felt sense oriented meditation, deep breathing, vocal toning, spontaneous movement and dance, yoga, listening to soothing music, spending time in nature, running, or hiking. Or simply receiving a hug from a loved one, which releases oxytocin, a natural hormone produced by the pituitary gland that promotes bonding and connection.

Practices such as yoga and time in nature help to release stored trauma. 

These are tools to deactivate the sympathetic response and activate the opposing parasympathetic response, called the rest and digest mechanism. The goal is to feel safe. To regulate breathing, slow the heartbeat, and circulate blood back to the vital organs

These powerful practices change our physiology and affect our mood. The next time someone suggests it’s all in your head, you will have a different response. This knowledge empowers us to heal past wounds. Through acknowledging the power trauma plays in your life and understanding the mechanisms by which healing occurs, you can create a more embodied, joyful life.

This article originally appeared on upliftconnect.com and was written by Melody Walford.

Cervicogenic Headache: Neck Headache

Neck Headache, or as it is known medically - Cervicogenic Headache, is a secondary headache disorder. In other words, your headache is caused by a neck joint problem.

The good news is that by fixing your neck problem, your neck headache can be alleviated. Researchers feel that neck headache accounts for between 4% to 22% of all headaches seen clinically. (Racicki et al 2013; Watson 2014)

What's Causes Your Neck Headache?

Your neck headache can originate from a variety of musculoskeletal and neurovascular structures in your upper neck; including the upper three neck joints, C2/3 disc, spinal cord coverings and neck muscles. A dysfunction in these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003).

Upper Neck Joints

The most likely sources of your neck headache is dysfunction of either your upper neck joints, neck muscles or nerves, which trigger pain signals that travel to your trigeminal nucleus in your brainstem, where you interpret the pain signals as a neck headache.

The most common cause of neck headache is dysfunction of your upper three neck joints. The most common neck joints involved are your:

• Atlanto-occipital joint (O-C1), 
• Atlanto-axial joint (C1/2), and 
• C2/3 cervical spine joints.

In simple terms, your neck joints can cause a neck headache or pain if they are either too stiffor move too much (eg wobbly and unsupported by weak muscles) or are locked in an abnormal joint position eg. locked facet joint or poor posture. 

Once your neck joint becomes stressed and painful, the pain signals are referred to the trigeminocervical nucleus in your brainstem... and you start to feel a neck headache or, in some cases, face pain!

Your physiotherapist is expert in the assessment and correction of neck joint dysfunctions that result in neck headache. Their professional diagnosis and treatment is essential for neck headache sufferers.

Neck Muscles

Your neck and shoulder blade muscles that originate from your neck will cause pain if they are overworking, knotted or in spasm. 

Some of your neck muscles overwork when protecting injured neck joints. Other neck muscles become weak with disuse, which places further demand on your overworking muscles resulting in muscle fatigue related symptoms. 

Your neck muscles work optimally when they have normal resting tension, length, strength, power and endurance.

Your physiotherapist is expert in the assessment and correction of muscle imbalances that result in neck headache.

Cervical and Occipital Nerves

Nerves in your upper neck may be directly pinched by extra bony growths eg arthritis, disc bulges or swelling. The results can result in nerve irritation or a reduction in neural motion known as neuromechanosensitivity or abnormal neurodynamics. 

Irritation of your upper neck structures refer pain messages along the nerves and cause your headache.

In simple terms, your neck is the "switch", nerves are the "power cords" and your headache is where the "light" comes on.

What are the Symptoms of Neck Headache?

Neck headaches can often be misdiagnosed or confused with other sources of headache, including migraine, since the head pain is typically felt in the same area as a migraine. 

It is really the interpretation from your headache physiotherapist of the whole combination of your symptoms plus the findings of your physical examination that will confirm a neck headache diagnosis

Commonly, neck headache sufferers will usually notice:

• Tenderness at the top of their neck and base of the skull. 
• Neck stiffness or a mild loss of movement, although this is sometimes is only subtle and needs to be confirmed during your physiotherapist's physical examination.

One of the main differences between neck headache and migraine is that physiotherapy treatment of your neck is able to alter or relieve your headache immediately.

Common Characteristics of a Neck Headache?

The following symptoms are characteristics of a neck headache. You may experience any one or several of these symptoms:

• Your headache may seem to radiate from the back to the front of your head.
• Your headache is provoked or eased by a neck movement, a sustained posture, stomach sleeping or with your head turned to one side.
• Your headache normally appears to be worse on one side of your head. The side is normally constant and does not swap sides.
• Your headache appears to temporarily ease up when you apply pressure or you massage your neck or the base of your skull.

If you experience any of the above symptoms, you are more likely than not to be suffering a neck headache. Please inform your physiotherapist and they will assist you.

What if Your Neck Isn’t Sore?

Even if your neck isn’t sore or painful, you can still experience neck headaches. It is important to remember that your neck joints may NOT be sore at REST, but they may be tender to touch or painful on movement. 

Neck joints that are sore at rest will normally be very tender to touch and painful at the extreme of movement. Obviously, this scenario is a more severe neck headache.

If your headache or a migraine has been present for years and your neck has not been examined, then a thorough neck examination is recommended and is appropriate to eitherconfirm and treat your neck headache or exclude a neck disorder as the cause of your headache.

How is a Neck Headache Diagnosed?

Accurate diagnosis is important to guide the correct treatment and management your neck headache. Headache and head pain can have many causes, not just neck headache or migraine. Correctly identifying the cause will lead to better treatment.

This article originally appeared p physioworks.com.au and was written by John Miller.

Photo by Jacob Morrison on Unsplash

Depression is a physical illness which could be treated with anti-inflammatory drugs, scientists suggest

Depression could be treated using anti-inflammatory drugs, scientists now believe, after determining that it is a physical illness caused by a faulty immune system.

Around one in 13 people in Britain suffers from anxiety or depression and last year the NHS issued 64.7 million prescriptions for antidepressants, double the amount given out a decade ago.

Current treatment is largely centred around restoring mood-boosting chemicals in the brain, such as serotonin, but experts now think an overactive immune system triggers inflammation throughout the entire body, sparking feelings of hopelessness, unhappiness and fatigue. 

It may be a symptom of the immune system failing to switch off after a trauma or illness, and is a similar to the low mood people often experience when they are fighting a virus, like flu.

A raft of recent papers, and unexpected results from clinical trials, have shown that treating inflammation seems to alleviate depression.

Likewise when doctors give drugs to boost the immune system to fight illness it is often accompanied by depressive mood - in the same way as how many people feel down after a vaccination.

Professor Ed Bullmore, Head of the Department of Psychiatry at the University of Cambridge, believes a new field of ‘immuno-neurology’ is on the horizon.

“It’s pretty clear that inflammation can cause depression,” he told a briefing in London to coincide with this week’s Academy of Medical Sciences FORUM annual lecture which has brought together government the NHS and academics to discuss the issue.

“In relation to mood, beyond reasonable doubt, there is a very robust association between inflammation and depressive symptoms.  We give people a vaccination and they will become depressed. Vaccine clinics could always predict it, but they could never explain it.

“The question is does the inflammation drive the depression or vice versa or is it just a coincidence?

“In experimental medicine studies if you treat a healthy individual with an inflammatory drug, like interferon, a substantial percentage of those people will become depressed. So we think there is good enough evidence for a causal effect.”

Scientists at Cambridge and the Wellcome Trust are hoping to begin trials next year to test whether anti-inflammatory drugs could switch off depression.

“There is evidence to suggest it should work,” added Prof Bullmore.

The immune system triggers an inflammatory response when it feels it is under threat, sparking wide-ranging changes in the body such as increasing red blood cells, in anticipation that it may need to heal a wound soon.

Scientists believe that associated depression may have brought an evolutionary benefit to our ancestors. If an ill or wounded tribal member became depressed and withdrawn it would prevent a disease being passed on.

However a link has taken so long to establish because until recently scientists believed the brain was entirely cut off from the immune system, trapped behind a ‘Berlin Wall’ known as the blood brain barrier.

But recent studies have shown that nerve cells in the brain are linked to immune function and one can have an impact on the other. Around 60 per cent of people referred to cardiologists with chest pain do not have a heart problem but are suffering from anxiety.

One in 13 people in Britain suffers from depression CREDIT: ANNA GOWTHORPE 

Figures also show that around 30 per cent of people suffering from inflammatory diseases such as rheumatoid arthritis are depressed - more than four times higher than the normal population.

Likewise people who are depressed after a heart attack are much more likely to suffer a second one, while the lifespan for people withcancer is hugely reduced for people with mental illness.

“You can’t separate the mind from the body,” said Prof Sir Robert Lechler, President of the Academy of Medical Sciences.

“The immune system does produce behaviour. You’re not just a little bit miserable if you’ve got a long term condition, there is a real mechanistic connection between the mind, the nervous system and the immune system.

“Our model of healthcare is outdated. We have a separation. Mental healthcare is delivered by mental health professionals, psychiatrists, mental health nurses and so on, often in separate premises from where physical health care is delivered and that is simply wrong and we need to find ways to ever more closely integrate and train amphibious healthcare professionals who can straddle this divide.”

Research has also shown that people who have suffered severe emotional trauma in their past have inflammatory markers in their body, suggesting their immune system is constantly firing, as if always on guard against abuse.

This article originally appeared on www.telegraph.co.uk and was written by Sarah Knapton.

Photo by: Photo by Nik Shuliahin on Unsplash

Yoga Now Standard Treatment for Vets with PTSD

Yoga's not usually the first thing that springs to mind when thinking about treatment for post traumatic stress disorder in veterans. But from the Veterans Administration to the Pentagon, yoga classes are becoming not just commonplace, but in some rehabilitation programs mandatory.

One of the places in the forefront of change is the Newington Yoga Center, in Newington, Connecticut.

About 20 veterans train to become yoga teachers. Suzanne Manafort of the Veterans Yoga Project, said what began as a small project has burgeoned into programs across the country. Manafort taught yoga for years before using it as a treatment for PTSD. She said she had no idea she might need to make adjustments to her teaching, until she made mistakes.

"Touching is a mistake. In yoga classes we touch all the time. But to somebody whose been sexually assaulted that's a huge violation. Walking behind them is a huge mistake because it feels like they have to pay attention to what's going on in the room instead of just practicing their yoga practice," Manafort said.

She said ultimately it was veterans themselves that guided her, in some cases just by the courage it took simply to stay in class.

"Some of the men and women that I work with are Vietnam Veterans so they've been at home suffering for 40 years," said Manafort. "And when they come into this treatment program and they're told they have to do yoga, 'they're like are you kidding me?'"

"I thought it was a joke," said Vietnam veteran Paul Gryzwinski. "And I remembered actually laughing out loud and they said no we're really not kidding you're going to be going to yoga."

Gryzwinski is training to teach yoga to veterans. Many years after returning from the war, PTSD hit him hard. He ended up turning to the VA. Where he first encountered yoga.

"And I just thought of myself in like, tights with you know a bunch of women. And I know that sounds sexist — and I'm not, so forgive me — but it was such an alien concept to me," Gryzwinski said with a chuckle.

And Gryswinski's early misperceptions are one reason that Dan libby, a co-founder of the Veterans Yoga Project, said the 12 week yoga training for treating vets with PTSD tries to strip all the new-agey stuff out.

"We really emphasize, 'leave all the Sanskrit names at home, right. Leave the candles at home, don't talk about you know moonbeams and chakras and all these things,'" he said. "It's really just about learning about your body and your experience; learning to breathe."

Lt. Col Melinda Morgan deployed right after 9-11 and started teaching yoga to those who had served and those who were preparing to go to Afghanistan.

"So I started teaching veterans 10 years ago and one of those veterans that I taught became an instructor himself. And so in 2007 when he was in Iraq and I was in another location, he writes me a note that said, 'I have to teach yoga and I don't think I can.' So I'm like, 'yes you can.' I wrote it down all of the poses, emailed it to him and helped him on his way to become a certified teacher," Morgan said.

Today, Morgan teaches at the Pentagon, and she said classes once sparsely attended are now full every day. But despite an increased demand for yoga paired with a growing number of alternative treatment programs in the military and the VA, there's scant hard science about why yoga or most of the other alternative programs work.

Yoga instructor Dan Libby hopes the government does some studies soon, because without more data, returning troops won't take the programs seriously.

This article originally appeared on pri.org
Host Marco Werman
Reporter Susan Kaplan

Links

• VetsYoga
• Veterans Yoga Project
• Give Back Yoga