The endo and mental health spiral
Did you know that endometriosis in strongly correlated to mental health issues? Many women with endo also suffer from burn-out, depression, anxiety, etc.
But did you also know that mental health issues in turn worsen endometriosis?
Feeling as sad as this panda? You're not alone. It's actually very common, and you can get better.
How endometriosis leads to mental health issues
The reason why endo leads to mental health issues isn’t too complicated.
For years our experience is being dismissed by both medical professionals and our social circle. We put on a brave face and try to act as if everything is normal, while it isn’t (often because we are being led to believe we overreact and our suffering is normal, we’re just weaker). We cross our boundaries on a daily base, eating into our mental and physical reserves.
Dark thoughts and their confirmation
While in pain, it’s easy to experience dark and ‘absolute’ thoughts. The more often we are in pain, the more often we experience this type of thoughts (like “I’m always in pain”, “I’ll never be able to lead a normal life”, “no one understands this”). When on top of this, our experience is being dismissed, these thoughts are getting confirmed. We in fact don’t find a solution, we in fact are alone with this experience and we in fact aren’t able to live a normal life. In the long run, it’s no wonder so many of us suffer depression.
Fear of pain and burn-out
When we’re finally not in pain for a day or more, we are often scared that it’ll come back. A big chunk of our mental space, subconsciously, is being consumed by this fear. This can lead to anxiety and social isolation.
It’s easy to cancel social engagements or renouncing on activities that we might find relaxing when we think the pain might come back anytime. For a long time I didn’t dare to make long mountain walks or go skiing, because what would happen if I had a flare-up ? I sure couldn’t call the helicopter to come get me because of a so-called ‘stomach ache’ that would surely be dismissed in the hospital (“your labs look fine”). I wouldn’t go climbing with friends anymore because what if I had a flare-up and someone would have to take me home? I didn’t want to be the kill joy for their nice saturday in the mountains.
So I stopped doing the activities that truely relaxed me, emptied my head.
The combination of filling mental space with fear + not being able to relax is the fastest and most direct road to a burn-out.
It means we are under constant stress, our mind never relaxes or lets go. We need to be on the look-out for danger. It’s the famous fight/flight/freeze state.
Mental health issues don’t just happen to ‘the others’
I am currently recovering from a burn-out, which I didn’t see coming. At all. I don’t have kids to stress about, I work from home in a job I love, I have a lot of free time and flexible hours, I am living in the beautiful Dolomites, I am a generally optimistic and happy person.
How could I, Eva, have a burn-out?
I guess I didn’t realize how consuming the fear of pain was for me, the energy I put into finding solutions, the fear of not being able to have a family. I wasn’t even aware of all of these thoughts.
But what I really wasn’t aware of, is how these in turn make endometriosis worse.
The mental health - inflammation cycle
Stress is good for us. That is, accute stress is good for us.
However, we (like most of us in today’s society) are under constant, chronic stress. This has been proven to change our DNA and lead to inflammation. Inflammation in turn leads to pain. You can restart at the top of this article and read what pain leads to. It’s a never-ending negative cycle.
On top of that, when you don’t feel very good mentally, it’s easy to make “bad” choices in other areas of your life.
When feeling tired, it’s easy to choose a night on the couch over a dinner with friends. Choose a frozen pizza over a healthy meal. Choose the car over the bike. Choose a movie over a walk.
Each on their own, and in limited amounts, are perfectly fine. But when these become our default state, we are in fact worsening endometriosis.
Healthy food fights inflammation, unhealthy food increases it.
Sports releases endorphins, staying on the couch will make us sleepy and feel unaccomplished, leading to more negative thoughts.
Sports also helps with muscle tone, reducing pelvic floor pain and lower back pain, all caused by a sedentary lifestyle.
Seeing friends reduces anxiety and releases endorphins, a few things a movie probably won’t do.
So how do we break this cycle?
The thing is, we kind of know this, right? I don’t think this comes as a huge surprise to anyone. But how do we break the cycle? Should we just power through fatigue and pain purely on discipline and willpower? I don’t believe so. That would just lead to more fatigue and in the long run you’ll burn out.
We do need to acknowledge the state we’re in.
We know where we want to end up, but all the good advice out there just feels like a 3rd, 4th or 5th step. What’s the first one? That’s why I developed the Endo To Energy framework. As the first steps to take, without consuming even more mental space and limited energy.
It doesn’t have to feel like you need to break the negative cycle on your own in order to be ready to implement the strategies you find online. The E2E framework is the way to break that negative cycle.
It assumes the worst: you’re feeling low, tired, and kind of desperate. Just like I did. I don’t assume you can follow a low FODMAP diet or start a regular work-out routine today. I assume all you can do today is order one supplement and add one extra plant to your diet. Step by step, day by day, you’ll get better and implement more. And I’m here for any support you might want.