I pivot my line of questioning. I start asking the patient what's going on their lives now. What was their childhood like? What were their parents like? And once you get this release valve, a lot of symptoms go away. Hey guys, welcome to another episode of the Wednesday check-up. Today I wanna talk about mind-body disorders. And I know that sounds like a froo-hoo topic, I promise it's not. It's something that's not talked about enough within the medical community. It's under-researched. And it can be contributing to millions of conditions all across the world without even us knowing about it. Mental health and physical health are truly one and the same. You can't have very good physical health without very good mental health. To give you some examples of how powerful the mind is in taking control over the body, let's take into consideration the placebo effect. Someone, let's say having a lot of pain, someone gives them a sugar pill that has no active effect on pain, but they tell them that it's gonna have an effect on their pain, voila, the person feels less pain and in general they think that they feel better quicker. Reflexively most people think that if they are given a placebo, it's only a mental effect. In reality, it's also an effect on your physical health. Because when a person has 10 out of 10 pain, as an example, their heart rate also goes up. That's an objective finding that we can use to gauge whether or not someone has pain. Once we give them a placebo, not only do they feel that they have less pain, but their heart rate drops as if they're actually experiencing less of that pain. This works also the same way on the other side of the spectrum. If you're having, say a lot of stressors in your life, you're suffering with some sort of mental health condition, your blood pressure can be high. I've realized that we don't put enough emphasis on this mind-body connection. And I'll tell you what I mean. Very often, as a society, as a culture, we want to tie everything back to a physical cause. If someone has elbow pain, if someone has low back pain, even if someone has a condition like a chronic cough or acid reflux, we're always ready to tie it back to a physical condition. If it's not there, we say, "Well then, we don't know what's going on." And we label it idiopathic, which is the medical term is we have no idea what's going on. What I started doing, after doing some research and reading some really good books on the subject, is understanding that patients can have physical symptoms as a result of what's going on in their mental state. What your own mind is doing is trying to figure out how to best distract you from some of these horrible, what your mind labels as life-threatening emotions, and distracts you with some physical symptoms. Makes you repress these emotions. And the more you repress these emotions, the more that they can overflow and cause complicated symptoms. I have patients that come in with horrible low back pain. And as we move through the process of understanding what anatomy is there, trying to rule out, is everything okay from a physical cause, getting a thorough history. Once we get to the point where I have a strong enough suspicion that I think that there's a mental aspect to this pain, I pivot my line of questioning. I start asking the patient what's going on in their lives now. What was their childhood like? What were their parents like? What emotions are they feeling very powerfully right now? And once you get this release valve, a lot of symptoms go away. Now I'm not saying this is right for everybody or this should be your first line approach, but I'm just saying this is something that I've noticed work incredibly well within my patient population. Being an osteopathic doctor, someone that has a sports medicine focus, I've been treating patients with pain, sports injuries, neck pain, shoulder pain for a very long period of time. Up until I started incorporating more mental health questions in my sports medical diagnoses, I wasn't having a lot of success. There's an important line of questioning that needs to be addressed within the mental state that often goes overlooked. But we should not be blaming doctors for this. Or at least solely blaming doctors. Nowadays, we have such an influx of patients, and with decreasing amounts that we're getting paid per patient, it's very difficult when you have 15 minutes or even 10 minutes with a patient, to think in this broad scope of whole patient and give adequate care. That's why I make sure that whenever I'm meeting a patient for the first time, or I know a patient is coming in for a complex diagnosis, I spent more time with that patient. Because we need to take into consideration all of the things that could be causing these symptoms before jumping and getting pigeonholed into a single diagnosis. A very common question, and maybe something you're even thinking about now is, how does my mind make my back hurt or my shoulder hurt? Research has been tremendously underfunded when we're talking about mind-body disorders. A doctor who's made tremendous strides in this field by the name of Dr. Sarno. He talks about a condition called TMS, which is tension myositis syndrome, or tension myoneural syndrome, where basically the mind, in order to distract your conscious from focusing on these repressed unconscious emotions, actually decreases a little bit of blood flow to a muscle. And a muscle that specifically in your mind you know you're weaker in, or that you use often, and when you have a decrease in blood flow, just how if you have the air conditioner blowing on your neck and you wake up with a stiff neck, that can cause a muscle to spasm or to function poorly. He's actually done some really interesting trials in showing tremendous cure rates, not just treatment and symptom-resolving rates, but cure rates in patients who were having these problems like low back pain, shoulder pain, neck pain. Now I understand how hearing Dr. Sarno's theory can feel like, it's a little bit far out. Things to take into consideration: When I as a doctor spend extra time talking to my patients about mindfulness, it's not a waste of time, 'cause it's gonna help them in other ways, even if it doesn't solve their physical problem that they're coming to see me for. Second, it doesn't cost them any more money. I'm not selling them anything. I'm not doing anything for any self-interest purposes of mine. And the most important thing is it's low-risk. I'm not sending them for a surgery that can go horribly wrong, and they can have a permanent defect in their body. It's just a little harmless conversation that can actually benefit them even if it doesn't cure their original problem. You're probably wondering to yourself, well what's my role in this? No doctor has ever asked me about my mental health when I came in for my chronic low back pain. First and foremost, have a primary doctor. There's been articles coming out lately that young folks, millennials specifically, don't have primary care doctors and are resorting going to urgent care centers and telemedicine sites. It's not an optimal solution. You need to have a quality family medicine doctor, or internal medicine doctor, who knows your history, who knows what's going on in your life, who has the time to take this line of questioning. And that can only happen if you have a primary care doctor. But one who practices with a holistic approach. The second part of this is it's up to you to be very honest with your doctor. If a doctor asks you questions about your mental health, or asks you what's going on in your life, don't just brush off all your worries and stresses and very powerful emotions that you're feeling and say "I'm okay." That's a very simple thing that you can do in order to get the best treatment. I know this was a little bit dense, but I think these are conversations that we really need to be having. And with mental health getting so much publicity nowadays, I feel like this is what we should be talking about. Because this way, we can influence doctors. We can influence researchers. And most importantly, I can influence you to think about this yourself and to ask your doctor the right questions. I'm gonna have some resources down below in the description box. If you're comfortable sharing your questions, drop 'em down below. I am active in the comments section and I do have my monthly responding-to-comments video. And I am gonna be looking at this video's comments specifically to answer and give you guys some guidance. As always, stay happy and om.
