TV therapists NIK and EVA SPEAKMAN reveal their top tips to get your diet back on track
Given up on all your weight loss resolutions already? TV therapists NIK and EVA SPEAKMAN reveal their top tips to get your diet back on track and beat those January blues
There is every chance you started the New Year on a fad diet or healthy eating regime but now the January blues have set in and resolutions are being broken.
Whether it’s sneaking to the kitchen in search of cake, running to the shop to satisfy a chocolate craving, or tucking into family-size bags of crisps, you may find it impossible to stop sabotaging all of your best weight-loss intentions. It can be so hard to understand why you’re rummaging through the fridge when you want nothing more than to be slim and healthy.
But don’t panic because we know exactly what’s happening – and we can help. As a married couple, we’ve been working together as therapists for 22 years. We’ve trained in numerous psychology and psychotherapy practices and we have worked with thousands of clients in person, at our workshops, and on live television, helping them to meet their weight-loss goals, to feel great and to transform their lives.
As a married couple, we’ve been working together as therapists for 22 years (pictured Nik and Eva Speakman)
Now we have written a book, Winning At Weight Loss, which reveals our tried and trusted methods for putting you back in control of what you eat. We can help you understand why you overeat and help you break the destructive habits you might have been carrying around for decades. You’ll develop new ways of thinking and sever any obsessions with food to enable you to transform your weight and establish a healthier, happier life.
Trust us, this advice will make a significant difference to your relationship with healthy eating and exercise. We understand how frustrating it is to find yourself overeating. You might look at us and assume we are naturally slim, but we have been on a journey of self-analysis for more than 20 years and we are proof our methods work.
When we met 29 years ago, Eva had a terrible relationship with food. She was a self-confessed chocaholic and would sneak to the kitchen in the middle of the night for her ‘fix’. Nik was a classic fussy eater who’d do anything to avoid fruit and veg.
But we’ve applied our principles to ourselves and we are living proof that they work. And the following pages are filled with tips and tricks to show you how.
Banish chocolate cravings forever! Lose weight faster than ever with our simple techniques to break bad habits
When so many of us are on a diet or trying to eat healthily, it is infuriating to find yourself overeating and preventing yourself from achieving your weight-loss goals. The problem is, food is so-often a ‘go-to’ crutch when we’re sad, mad, lonely, bored, disappointed or stressed.
If you are sleep-deprived, your body will crave energy and search for a quick source (like cakes), and irrespective of how focused and motivated you are to lose weight, a lack of sleep can cause you to overeat.
You might find yourself eating forbidden foods because you are bored, because you like the ‘crunch’, or just because they are forbidden.
Diets inevitably mean restriction and there’s nothing like telling yourself that you CAN’T have something to make you want it more. We also hear stories of perpetual yo-yo dieters who endure a never-ending battle with weight loss, and often face the additional anxiety of wanting to avoid eating in front of others and being photographed. This stress can exacerbate cravings and make self-sabotage more likely.
When so many of us are on a diet or trying to eat healthily, it is infuriating to find yourself overeating and preventing yourself from achieving your weight-loss goals (pictured, Eva Speakman)
Drop those unrealistic expectations and accept that it is OK to overindulge from time to time, and don’t punish yourself if your diet has ‘failed’. When you were learning to walk, you will have fallen over repeatedly. An occasional bar of chocolate doesn’t mean you’ve failed at weight loss – you are merely working towards the perfect act of healthy eating.
If you get frustrated with yourself for lingering too long at the buffet table, ordering crisps with your glass of wine or mindlessly moving your hand repeatedly from a plate of biscuits into your mouth when everyone else in the meeting seems perfectly able to resist, it is worth thinking about whether you are a creature of habits formed in childhood, or whether you are just following patterns established by friends or colleagues.
SHOP YOUR WAY TO GOOD HEALTH
1. Keep a detailed food diary for two weeks.
2. Highlight all the foods you know sabotage your slimming success.
3. Beside each, make a list of possible alternatives or substitutions for these foods.
4. Use a different-coloured highlighter pen to mark all the healthy choices that appear in your food diary.
5. Create a new shopping list based on your healthy food choices and all the healthy alternatives to your trigger foods.
The key to breaking bad habits is replacing them with good ones: think of a buffet table as a great opportunity to pile your plate with salad, change your drink of choice to snap the snack connection, and chew sugar-free gum whenever biscuits appear.
When you’re trying to work out your triggers, keeping a detailed food diary – of exactly what you eat and drink, when and with whom – will help make you consciously aware of what you are consuming, and also accountable.
You owe it to yourself, to be in control of how and what you eat, and writing your food diary is a big step towards that.
ARE YOU AN EMOTIONAL EATER?
If you find yourself craving unhealthy foods even though you are not hungry, don’t blame poor willpower. In many cases, a craving is your body crying out for the feelgood effects that junk food often provides. That’s because the food we enjoy helps to release hormones that boost our mood.
As endorphins (chemicals produced by the body to relieve stress and pain) are released, your pulse speeds up and you experience positive feelings – it’s like falling in love! These hormones offer comfort when we’re feeling sad, lonely or in need of a little love.
Research suggests that we actually get two hits: when we first ingest the food, and again when it reaches the stomach. But this elation is short-lived as the hormone disperses, and you will inevitably be left feeling discomfort and bloating, and perhaps embarrassment, guilt and shame.
As a brief distraction, fatty, sugary food can temporarily silence uncomfortable or unpleasant emotions such as loneliness, fear, sadness, anxiety, heartbreak and resentment – it can be a plaster you use to try to cover any wound.
We often find people are, without realising it, using junk food to rekindle the comfort of childhood when chocolate and sweets are so often given as a reward or treat. That’s why you might hear a voice inside your head saying: ‘Go on, you deserve this, you’ve been good today.’ There’s no doubt that an occasional treat can do you good, but unhelpful patterns can swiftly start to form if unresolved issues from your past are still causing emotional pain and making you regularly turn to food for solace.
Ice cream can sometimes seem like your new best friend if you’re feeling unloved or undervalued. But the buzz of reward will usually be short-lived, and if you’re on a diet, that tub of cookies and cream could be enough to make you throw in the towel, which will only dent your self-esteem more.
NIK and EVA SPEAKMAN: We often find people are, without realising it, using junk food to rekindle the comfort of childhood when chocolate and sweets are so often given as a reward or treat
We have found in some cases an old problem (even back as far as childhood) could still be haunting you and triggering food cravings decades later. If the discomfort you feel now when you think about a particular event feels like more than six out of ten, it could be significant. In many cases, merely making that connection could be enough to put you straight, or talking through these memories with someone you trust might help to reduce the chances of you searching for comfort in food.
Eva was made to feel inadequate in the past and ended up subconsciously using food as a way of punishing herself. (‘I’m fat and no one cares, so I might as well eat this anyway.’)
The most common cause of self-sabotage, low self-esteem and self-medicating is bullying, which ultimately leads people to give up on diets or exercise plans because they don’t believe they deserve to look and feel good.
If you have been made to feel useless and a failure, it is very common to sabotage your own slimming success in the belief that your efforts are futile. It is a form of self-punishment.
Once you have identified the events and the beliefs that lie behind your unhelpful eating patterns – and are preventing you from losing weight – you can take action to address them. Our mirror technique is a great way to flip self-destructive thinking and we have seen it can be powerfully effective in putting you back in control of your eating behaviour.
10-MINUTE TRICK TO CUT OUT JUNK FOOD
This simple technique is based on linking the foods you love to foods you would never eat – preferably those that make you retch at the thought of them.
We use this technique on ourselves and our relatives, and we are delighted to tell you that we haven’t eaten crisps or chocolate for more than 12 years now. Whenever Eva thinks of chocolate, images of tripe spring into her mind, and our daughter uses images of liver to curb her chocolate cravings.
One of our clients told us whenever she thinks of biscuits, all she can see is squid. The best thing about the method is that, if carried out correctly, the desire to eat these foods is extinguished indefinitely.
1. Pick the ‘vice food’ which sabotages your weight-loss attempts – perhaps it is chocolate, cake or crisps.
2. Close your eyes and imagine the face of somebody you love unconditionally in front of you. Put out your hand to where you see them – it is likely to be right in front of you, very close to your face.
3. Now try the same exercise with someone you haven’t seen for a long time (perhaps an old teacher). You should notice their image feels further away and is less clear. We tend to code important people – and foods – as being close to us, but we code the less important things further away. Any food you adore will be visualised close to your face, and foods you detest will seem much further away.
4. Close your eyes and imagine your favourite food. It should feel close, clear and brightly coloured. Put your hand where you can see it and open your eyes. Remember that position.
5. Next, think about a food that makes you feel nauseous or previously made you vomit (try tripe, raw liver, raw fish, squid, sour milk or offal). Close your eyes and imagine this food. The image is likely to seem unclear or blurred, and further away and very low down, perhaps on the floor. Put out your hand to this place, then open your eyes and be aware of where you see this food.
6. Now make the big switch: move the food you enjoy to the position of the food that you would never eat. Imagine that the food you like is on a tight bungee cord attached to you. Cut that cord and release that food, watching it fly to and land in the food you detest.
7. Repeat the process four or five times, seeing yourself releasing your favourite food and allowing it to drop on to the hated food, becoming tangled in a stomach-churning goo. Take time to imagine your favourite food mixing with the hated food. Start to diminish the colour and clarity of this image as your favourite food becomes tainted with the food you hate.
8. You should now notice that when you think of your favourite food, it will be somewhere it the distance alongside the foods you hate. Before long, merely thinking about it will make you feel queasy and you will lose all urge to eat it. Avoid the temptation to test the theory as tasting the food could erase all your efforts and you’ll need to start the process again.
Decide to be a victor, not a victim. If things from your past continue to affect you, then you are still a victim of that person or event. Make a decision today that you will be the victor of your past: you survived it and you are prepared to alter your perspective to set yourself free.
HOW TO INCREASE YOUR SELF-ESTEEM
One of the most powerful ways to reset your behaviour around food is to raise your self-esteem. It might sound like a monumental task, but in hundreds of cases we have been able to show this perceptual shift really does work because the better you feel about yourself, the more likely you are to want to invest in your health and your future and treat yourself to good food and regular exercise, instead of trying to stamp down on any bad feelings with chocolate.
NOW TRY THE MIRROR TECHNIQUE
This is so powerful that it can transform your behaviour overnight. One client told us she lost 2st after trying it. You will need a notepad and pen, and a voice recorder on your phone.
1. Stand in front of a full-length mirror. While looking in the mirror, write down or record everything that you see and say about yourself. What kind of person do you see in front of you? Are you strong? What do you look like? Do you see any weaknesses? If so, what are they? Write everything you perceive about yourself. Describe the person in front of you, both visually and emotionally. How do you feel about that person? Look at all your body parts and write down what you see.
2. Now count how many of the things you have said about yourself are negative and how many are positive.
3. Focus on the negative comments and ask: ‘Would I ever say those negative things to a stranger?’ If not, why not? Would you ever say them to a friend, child, partner, parents or loved ones? If not, why not? Is it because these words are mean and unkind? If they are not acceptable to say to anybody else, they are not acceptable to say to yourself.
4. Look at your list of negative comments and ask if someone else has said these things to you or somehow made you feel this way. Write a new list of the people who might have contributed to these unkind comments.
5. Ask yourself why you would want to listen to that person – what qualifications do they have to judge you? Are they even a part of your life? If not, that is because they are not important to you. If they are still a part of your life, consider why they may have said those things to you. Could they be envious or jealous of you? Are they scared of losing you? (Perhaps by knocking your self-esteem, you might be less likely to leave them and more likely to appreciate them more.) Is it because that person felt bad about themselves and in an effort to make themselves feel better they had to knock you down? Is it because they feared you would supersede them in life?
6. Once you realise the words you use to describe yourself aren’t yours but based on somebody else’s or how somebody else has made you feel, it’s time to view yourself through the eyes of love.
7. Stand in front of the mirror and close your eyes and think of someone who loves or loved you unconditionally, either now or in the past (a partner, a parent, a best friend, a colleague, a teacher, a pet or even someone who has died). Imagine that person standing beside you and see yourself floating out of your body and into that person’s body, and looking through their eyes at your reflection in the mirror.
8. Say out loud (you can dictate it into your phone) everything that person sees or saw in you. Looking in the mirror, what do they see? How do they describe you? Why do they love you? Do they think you are beautiful, kind, intelligent, fun to be around, that you are loyal, perfect, a good cook, good at making them feel special or loved? Do they compliment you about your hair, eyes, figure, stature or smile? Say it as they said it, with love, sincerity and meaning.
9. Now, in the knowledge that the person who loves or loved you is not a liar and that their feelings towards you were honest and true, press play on your voice memo, and with your eyes closed again, imagine seeing yourself in the mirror through the eyes of your loved one and listen to all the words that person said about you, everything they love about you. Listen to the words four or five times.
10. Very slowly open your eyes and see yourself in that mirror through the eyes of love. See yourself in the knowledge that the person who said all those lovely things about you did so because they were true, because people do not give compliments without reason. Nor do people give love without reason. Love is earned, and if anyone has ever loved you unconditionally, that is because you have earned it and because you are lovable.
11. Now write down all those compliments and positive things that your loved one said about you and keep them somewhere prominent. This could be at the side of your bed, on your desk at work, or in your wallet.
12. Whenever you need to remind yourself of how amazing you are, how loved you are and that you deserve to be happy, healthy and to have a positive relationship with food, reread this list and hear your loved one’s voice as you do so.
Learn to LOVE exercise in just seven easy-peasy steps
Exercise might be a fast-track solution to increased health and weight loss, but for many people the prospect of physical activity will seem about as exciting as watching a radiator cool down.
Yes, exercise releases feelgood brain chemicals, but so does eating delicious food.
And given the choice, most of us will opt for food, as it requires less effort and can be combined with other pleasurable activities, such as watching TV or socialising with friends.
NIK and EVA SPEAKMAN: Exercise might be a fast-track solution to increased health and weight loss, but for many people the prospect of physical activity will seem about as exciting as watching a radiator cool down
Many people find the whole concept of exercise a struggle. But as long as there is any trace of a negative association with exercise, there will be a barrier which will inevitably lead you to look for excuses as to why you CAN’T exercise, as opposed to focusing on reasons why you CAN.
But when 20 million Britons are inactive to the detriment of their health, we need to take action NOW.
Try our tried and trusted motivational techniques to help you overcome the barriers that may stand in your way, helping you to become healthier, fitter and lighter.
YOU DON'T HAVE TO LEAVE HOME
You don’t need to join a gym to boost your activity levels. You can get fit at home with vacuuming, gardening, walking up and down your stairs – even choreographing your own dance routine to your favourite music in the comfort and privacy of your own home.
You can also use everyday household items to help build strength, such as cans of food, water bottles or even your baby (carefully!).
Eva would hold our children when they were babies while doing squats, chest presses and sit-ups, and would also power-walk while pushing them in their buggies.
Finally, if you are one of those people who has an exercise bike hidden under an enormous pile of clothes in your bedroom or else it is sitting in your shed, then how about dusting it down, creating a motivating soundtrack, and taking two bottles of water to use for some bicep curls and shoulder presses while cycling?
CREATE YOUR OWN VISION BOARD
Either find a photograph of yourself when you were at a weight you would like to return to or a ‘realistic’ picture of how you would like to look, and pin it to your board. Write your weight goal on your vision board and use Post-it notes or a chart to document the reduction in your size in centimetres, inches, pounds or kilograms. Keep your vision board in a visible place, so that you can look at it and appreciate it daily.
SET YOURSELF CLEAR GOALS
Create clear and realistic goals of what you would ultimately like to achieve: a dress size you’re aiming for, a target weight or the number of centimeters or inches you would like to lose from your waist or your thighs.
Note down small targets on your journey to give yourself a sense of achievement, and also reward yourself with treats along the way.
Sign up for organised charity walks, runs or bicycle rides as part of your health journey.
BUDDY UP FOR EXTRA MOTIVATION
We are often prepared to do more for others than we will do for ourselves, which is why exercising with a friend is a great way to keep you both on track and motivated.
Some people also respond better to healthy competition, so sharing your journey and competing with each other can help give you both a boost.
BOOK CLASSES... AND KEEP A NOTE
If you have a hair or dental appointment, you’ll note it in your diary so that you won’t miss it. If something else clashes with these appointments, you are likely to decline and offer an alternative date and time instead.
We would recommend the same process with your exercise routine.
Make it a diary appointment or book yourself a place in an organised class, and then put a lovely big tick at the side of it when you have completed your exercise.
GROUP EXERCISE IF MUCH MORE FUN
You'll find people of all different ages, shapes and sizes in an exercise class. It is also a great opportunity to meet new friends, and is often more fun and motivating than exercising alone. Local gyms, swimming baths, churches and social clubs will offer a variety of options for a variety of fitness levels.
REMEMBER THOSE HAPPY TIMES
Cast your mind back to any happy occasions in your life when you laughed uncontrollably, when you fell in love (either with a person, place or pet), when you were given a compliment or achieved something, or a special place or memorable experience.
Use this as a prompt to remember how incredible you are and what fabulous things you have seen, experienced, tried and been part of.
This will provide an instant boost to your self-esteem, which will make you more likely to get to the gym or get out on your bike.
LIFT WEIGHTS TO BURN MORE FAT
Weight-lifting is a significant component to weight loss, health and strength, and should not be underestimated. Using weights promotes weight loss because muscle helps you burn more calories. The more muscle you have, the higher your metabolic rate. Research shows that your body continues to burn calories after a lifting workout: the lean muscle mass you build from weight-lifting will speed up your resting metabolism. You’re more likely to burn body fat, instead of muscle, when you lift weights.
Adapted by Louise Atkinson © Mental Health Media Limited, 2019
Winning At Weight Loss, by Nik and Eva Speakman, is published by Orion Spring, priced £14.99. Offer price £11.99 (20 per cent discount) until February 18. To order, call 01603 648 155 or go to mailshop.co.uk. Free delivery on all orders – no minimum spend. Winning At Weight Loss is also available as an audiobook.
AdvertisementThe 16 most popular products of 2019
We all know the immediate nostalgia that sets in at the start of a new year.
Ringing in Jan. 1 means looking to the future, but it's also quickly followed by memories from the 365 days prior and all the noteworthy milestones worth looking back on.
We were curious about the most popular purchases in 2019, so we studied our website traffic, data from retailers, and information from stories we published this past year to determine which products were the most popular of 2019.
Here are last year's 16 frequently bought items that you may want to consider for your 2020 shopping list.
There's no better way to feel like you're living in the future than by having a robot clean your house for you. iRobot's robot vacuums have been hot sellers for years now, but the Roomba 675 was a particularly popular buy for 2019.
Weighted blankets have caught on in recent years as a way to calm anxiety and promote a more restful night's sleep. This 10-pound blanket from Sharper Image won devotees in 2019 because of its breathable, super-soft velveteen exterior that makes it a year-round option. BPA-free, high-density microbeads are evenly distributed throughout the blanket to target your body's pressure points. It's not just for a good night's sleep, though -- curl up with this blanket on the sofa when you're watching TV or reading to help soothe anxiety, too.
Cast iron cookware has been around for decades and is a classic kitchen addition, but the cast iron skillet has had a particular recent resurgence. This Lodge skillet in particular topped shopping lists in 2019. Available in both 3- and 5-quart options with lids, it's versatile enough to be used in the oven, on the stovetop, or even over an open fire. That means you can use it for frying, sauteing, deep-frying, and even baking.
As self-care has become a collective fixation in the last few years, people have focused on both emotional and physical wellbeing. An air fryer strikes the perfect balance: letting you enjoy craving foods guilt-free while also cutting down on heavy fats. It's no surprise that the appliance has become so popular. This Ninja model lets you air fry your favorite foods with up to 75% less oil than the usual frying methods, and its 4-quart nonstick basket can hold plenty of food and is dishwasher-safe for easy cleanup.
The Nespresso represents the marriage of the convenience of a single-cup coffee brewer and the rich taste of artisan, freshly roasted beans. Discerning coffee drinkers loved this gourmet espresso machine in 2019 -- and for good reason. Thanks to its capsule system, it can brew actually good-tasting espresso and coffee with the touch of a single button, so it's as convenient as other pod brewers but makes tastier coffee.
Timepieces have always been a practical accessory as well as a status symbol, and the latest and greatest trend in wearable tech has been the smartwatch. It's easy to stay constantly connected whether at the gym, at work, or anywhere else, and the lastest Apple Watch in particular was a big seller in 2019. The most noteworthy feature of the gen 5 model is the always-on Retina display that keeps you from having to touch the screen or raise your wrist to check the time or read a text.
Modern life is all about balancing busy schedules with healthy lifestyles. Instant Pots only seem to get more and more popular each year since the creation of the appliance in 2009, and the Duo 60 was a top seller in 2019. Its 14 one-touch Smart Programs make operation a breeze, too, and the safety features provide peace of mind. The 6-quart capacity can also feed up to 4 people, which makes it a solid option for families.
With so many new shows and films available to stream at home, TV technology is always improving to keep up with the striking cinematography that now sets the standard. This crystal-clear 4K model from Samsung was an especially big hit in 2019. Its screen provides vivid colors from every angle and can minimize glare for a better viewing experience. The LED backlighting helps sharpen details, too, and the automatic built-in adaptation technology means you'll always have the ideal brightness and sound for the conditions in your room.
2019 was the year that seemingly everyone wore Airpods. The Pro version of these super-trendy wireless headphones was released in late-2019, offering significant upgrades on the original, such as active noise cancellation and tapered tips that conform to almost any ear shape. These not only look fashionable, but they also offer truly immersive sound and provide unmatched convenience for anyone who spends time on public transit, traveling, at the gym, or even in an office. These will likely continue to be popular into 2020 and beyond.
You don't have to be a fan of Star Wars: The Mandalorian TV series to appreciate the cuteness of Baby Yoda, which is why this Funko figurine was such a popular buy in 2019 (even though Baby Yoda didn't step onto the scene until November). So popular, in fact, that it's currently sold out on Amazon -- though we're confident that it will be restocked soon, considering the wide appeal of the Baby Yoda memes. Standing just under 4 inches tall, it's the perfect decoration for any desk -- or another great addition to a Star Wars fan's collectible case.
Amazon's Echo smart speaker has been a big seller since it was introduced, but the Dot model took the device to the next level. A voice-controlled speaker, it's the perfect companion for Alexa because you can just ask for your favorite music, news, or a weather report and the smart home assistant will take care of the rest. It also allows you to make calls and control any smart home devices with your voice. You can use it as an intercom to talk with family members in any room of the house, too, so it gives you total control over your domain.
In 2019, this gaming system was a big hit with gamers both young and old who appreciate the versatility of a console that can be used in multiple modes. That's because it's not just a single or multiplayer system for home use, but a device that can also be taken on the go for gaming anywhere. Best of all, in the portable mode, the battery can last up to 9 hours depending on the game you're playing.
If 2019 was the year of self-care, it was also the year of streaming. Whether you like to watch your favorite movies and TV shows on Netflix, Hulu, or the new Disney+, the Fire Stick is one of the most popular streaming devices around. This model was so popular in 2019 because it allows you to enjoy 4K ultra HD content so you can get the most from those streaming subscriptions you pay for. It also offers a voice-controlled remote with Alexa built-in, so it's easy to find the movies and series you're looking for.
Eco-conscious footwear had its moment in 2019, and Allbirds took off because these sneakers strike the balance between comfort, style, and sustainability. Finding shoes that feel as good as they look is no easy task, but these runners from Allbirds combine form and function perfectly. Made of merino wool, they're temperature-regulating and moisture-wicking, making them ideal for all kinds of weather. The shoes are also super soft and feature plenty of expert cushioning, but they're still durable enough to hold up well to regular wear, so the trend isn't likely to fade anytime soon.
Who isn't looking for healthy recipes that are easy to prepare during a busy work week? Plus, Whole30 was a hot diet fad of 2019 (and is still trendy now). This cookbook sold plenty of copies in 2019 because it contains delicious gluten-free, dairy-free, and grain-free recipes that don't lack anything in flavor. They all feature easy-to-find ingredients, too, so you won't have to spend hours shopping.
If you still have the Baby Shark song running through your head from time to time -- or if your kids are still singing it incessantly -- you won't be surprised that this doll was such a hot buy last year. Not only is it a soft, cuddly toy that your kid will love to hug, but it also plays the famous song when you squeeze its belly. You can even buy Mommy and Daddy sharks to go with your Baby to complete the family.
Jennifer Blair is a writer for BestReviews. BestReviews is a product review company with a singular mission: to help simplify your purchasing decisions and save you time and money. BestReviews never accepts free products from manufacturers and purchases every product it reviews with its own funds.
BestReviews spends thousands of hours researching, analyzing and testing products to recommend the best picks for most consumers. BestReviews and its newspaper partners may earn a commission if you purchase a product through one of our links.
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Tips for Managing Anxiety When You Have Ulcerative Colitis
Sam Cleasby was 23 years old when she was diagnosed with ulcerative colitis (UC) — an inflammatory bowel disease (IBD) that causes chronic inflammation and sores in the gut. Medication kept her flare-ups under control for nearly a decade. But in 2013, Cleasby required surgery to keep her disease under control. First, doctors removed her colon. Then they created an ileostomy, in which a piece of the small intestine is pulled through an opening in the abdomen so digested food can pass through a pouch called an ostomy bag, which she wears on the outside of her body. Later, they removed her entire large intestine.
“Though I had times when life was tough and I was sad, frustrated, or angry, I didn’t actually struggle with anxiety and my mental health until after surgery,” says Cleasby, founder of the blog SoBadAss, who says she also suffers from post-traumatic stress disorder (PTSD). “It wasn't the surgeries themselves but the loss of control that was the source of my panic attacks and anxiety,” explains Cleasby.
Around 30 percent of people with IBD suffer from either anxiety or depression, nearly double that of the general adult population in the United States, according to the Anxiety and Depression Association of America. According to Megan Petrik, PhD, a clinical health psychologist at the University of Minnesota in Minneapolis, symptoms of anxiety and depression often increase when IBD is active. A study published in May 2018 in the journal Inflammatory Bowel Diseases also found that people who underwent surgeries related to their IBD, as Cleasby has, were more likely to suffer from anxiety and depression.
In addition to coping with their illness, people with UC have to manage doctors appointments, medication, and changes to their lifestyle and eating habits, says Mira Zein, MD, a psychiatrist with Stanford Health Care in California. Flare-ups can also put a damper on socializing.
“When you lose control of your bowels, one of the most basic bodily functions, the feeling of losing control in the rest of your life is huge,” says Cleasby. “I was so scared of having an accident in public that I would avoid going out and became very isolated. And when you hide away in your home alone, it's easy to allow fear and anxiety to take over.”
According to the Mayo Clinic, signs and symptoms of anxiety include:
“People think a panic attack is all in your head, but it’s such a powerful physical thing. My hands would cramp until I couldn't move them, my chest felt like it was being crushed, I couldn't breathe, my vision would blur. It’s terrifying,” says Cleasby.
There is no evidence that IBD is caused by stress, anxiety, or depression, says Dr. Petrik. However, the symptoms of IBD, along with many other diseases, often worsen in times of stress, according to a study published in October 2019 in the journal Frontiers in Pediatrics. For example, stress may be related to a flare-up of symptoms like abdominal pain or diarrhea, says Petrik.
“When the body's stress response is activated, it can result in physiological changes in the functioning of the digestive system,” explains Petrik. According to the American Psychological Association, chronic stress can also weaken the immune system.
To help you manage anxiety while living with UC, follow these tips:
Talk to a Professional
Lawrence S. Gaines, PhD, a clinical psychologist at the Vanderbilt Inflammatory Bowel Disease Clinic in Nashville, Tennessee, says that working with a therapist or other mental health provider is an important part of managing ulcerative colitis. Cleasby agrees.
“I think the most important way to deal with anxiety and depression is to speak out about it. It's easy to feel so alone and that no one will understand you, but actually just voicing your fears takes away some of their power.”
Petrik recommends cognitive behavioral therapy (CBT), a type of talk therapy that helps patients develop skills to cope with emotional challenges, like those associated with UC. Acceptance and commitment therapy (ACT) is a type of CBT that helps people who suffer from a chronic illness manage their symptom-related anxiety. One study, published online in March 2019 in the journal Gastroenterology, found that two months of ACT reduced stress and anxiety levels in people who suffer from IBD by 45 percent after 20 weeks.
Petrik says to ask your doctor if there is a mental health provider on staff, or if your doctor can recommend a therapist that specializes in chronic illness or IBD. Psychology Today also maintains a searchable database of verified mental health providers across the United States. A therapist can help determine whether or not anxiety medication is a good fit for you.
Identify Stress Triggers and Explore Relaxation Techniques
According to Dr. Gaines, keeping baseline stress levels low through meditation, yoga, or other exercise can help keep a particularly stressful event from triggering anxiety.
“One thing I want is for people to be more relaxed, so if an adverse event happens, they will react to it but they won't go through the roof,” explains Gaines, who also recommends keeping a journal of thoughts so you can recognize what triggers anxiety for you specifically (it’s different for everyone).
“Recognizing the initial symptoms and heading them off with deep breathing and meditation works for me. But it's about finding what works for you,” says Cleasby. “Speak to your doctor about how you are feeling and to your loved ones. There is no shame in needing support."
Dr. Zein also recommends eliminating everyday stressors that could trigger anxiety with a few simple rules of thumb:
Zein suggests using relaxation techniques to reduce anxiety after it’s set in. These include breathing exercises, muscle relaxation, and meditation. “Oftentimes, using apps like Calm or Headspace can be really useful to guide people through these techniques when they’re feeling more anxious,” says Zein.
“One technique is to combine slow, deep breathing with muscle tensing and relaxing,” Zein explains. “Try balling your fists while inhaling, holding, and then releasing them slowly while exhaling is enough to relieve anxiety.”
Another technique is to inhale slowly while raising your arms overhead and exhale slowly while lowering them back to your sides.
Cultivate a Support System
To help you learn more about your disease and to form a network of people who are living through a shared experience, you can join online support groups or groups in your local area. According to a study published in 2016 in the Canadian Journal of Gastroenterology and Hepatology, peer support can help people who were recently diagnosed with IBD to not feel alone.
“Having good support is an important part of managing physical and mental health in IBD. Asking for and accepting help from family and friends is important,” says Zein.
And whatever your ritual, “It’s really important for people to develop coping skills that work for you,” says Zein.
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