Anxiety, Depression and Physical Health in Adolescents – What’s the connection?

Anxiety, Depression and Physical Health in Adolescence - What’s the connection?

With research finding ever-increasing evidence in support of the mind-body connection, there is no doubt that our mental functioning affects our physical health, and vice versa. The connection is a powerful one, and science is on well on its way to uncovering more of the detail. 

New research from Switzerland and Germany has found that in children and adolescents, certain physical diseases will be more likely to follow anxiety or depression. Similarly, particular mental health conditions happen more frequently following particular physical illnesses. 

Researchers have identified that depression tends to affect the stomach, while anxiety is more likely to affect the skin. Specifically, arthritis and diseases of the digestive system happen more frequently following depression or bipolar disorder, and skin diseases (such as atopic dermatitis) are more likely after anxiety. 

Researchers also found a strong association between epilepsy and subsequent eating disorders (including anorexia nervosa, bulimia nervosa, and binge eating disorder).

‘For the first time, we have established that epilepsy is followed by an increased risk of eating disorders – a phenomenon that had previously been described only in single case reports. This suggests that approaches to epilepsy treatment could also have potential in the context of eating disorders.’ Marion Tegethoff, lead author. 

This research is the first to explore the connection between these symptoms in adolescents, however previous research has found a similar relationship between in adults. Research involving adults has found that in people who have depression and arthritis, relieving the symptoms of depression also decreases the pain of arthritis. Similarly, people who have anxiety and atopic dermatitis report an improvement in their skin when they receive therapy for their anxiety.

In relation to the connection between eating disorders and epilepsy, the study refers to two earlier research studies, both with very small samples sizes, which have found some evidence to suggest that the connection might be because of the parts of the brain involved. When epilepsy arises from the right hemisphere, lesions in a part of the brain that has a close relationship with the limbic system may influence the development of eating disorders. At this stage, more research is needed, but it is a promising pathway for future research and possible treatment options.

The promise of this research is in widening the treatment options available to strengthen physical and mental health during adolescence. If we know there is a specific connection between certain symptoms, there is mounting evidence to suggest that treating one set of symptoms, has great potential to improve the other connected symptoms.

And finally …

Even with the strongest support, the greatest love, and the most committed and engaged parents in the world, many teens, probably all of them, will still struggle from to time. Adolescence will present itself with certain challenges to all teens. That’s the whole point of adolescence – it’s the time for them to stretch and push right up against their edges, to discover who they are, where they fit in, and how they will leave their very important mark on the world. All of our teens have it in them to be happy, thriving adults, but it’s not always easy to know exactly what they need to get there. Protecting their mental health is critical. We’ve always known that, but with our increasing wisdom on the mind-body connection, there is no doubt that when we guide and support them to stronger mental health, we are helping to strengthen them in mind, body and spirit.

7 Comments

Kristi

My 15 year old daughter suffers from JIA (Juvenile arthritis) and right along with it came depression and anxiety. She now sees a therapist that specializes in chronic disease management, medication administration and anxiety, and depression. She has seen decreased pain levels, better confidence in herself and future (self-efficacy) and an overall better outlook. Getting help was the smartest thing we ever did.

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No

Adolescents…adolescents…as theycontinue to wreck havoc and be wrecked havoc upon…some things never change…puzzling, why?

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Karen - Hey Sigmund

Ahhh yes – it’s all about what’s happening in their brains! Adolescence is a time of massive brain changes. Everything they do and everything they go through can generally be explained by these changes. It’s all part of their development towards being happy, healthy adults. Here is an article that explains it, and will hopefully make even their most confusing behaviour easier to understand https://www.heysigmund.com/what-you-need-to-know-about-the-adolescent-brai/.

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IBikeNYC

May I assume that “eating disorders” refers ONLY to eating too little as opposed to eating too much?

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Chrissy

My understanding (and experience as a parent) of an eating disorder is that it’s all about having a wrong relationship with food; whether it’s depriving or indulging, both are symptoms of a food obsession and a food fear at the same time. A right relationship with food is what we all want; one that brings ‘disorder’ into order, so that freedom can be found in a renewed way of thinking. It’s not impossible. But it takes time, love, patience and faith!

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Karen - Hey Sigmund

Yes – when this research talks about eating disorders, it is specifically talking about when those eating disorders co-occur with epilepsy. In those cases, there might be a common area of the brain contributing to the symptoms. Similarly, in instances where a teen has anxiety and skin problems, or depression and digestive problems, or eating disorders and epilepsy, it may be that they are somehow related. It doesn’t mean there will always be digestive disorders with depression, or skin problems with anxiety, or epilepsy with eating disorders, but when there is, it may be that treating one set of symptoms (as in the physical symptoms or the symptoms related to the anxiety, depression or epilepsy), may see an improvement in the other set of symptoms. It’s an interesting area of research because of the treatment options that open up when there are co-occuring symptoms, and also because of what it might mean about the possible causes of various symptoms.

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Karen - Hey Sigmund

Good question. The eating disorders part of the research included anorexia nervosa, bulimia nervosa, and binge eating disorder. I’ve amended the article to show this. Hope that clears things up.

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Anxiety is driven by a lack of certainty about safety. It doesn’t mean they aren’t safe, and it certainly doesn’t mean they aren’t capable. It means they don’t feel safe enough - yet. 

The question isn’t, ‘How do we fix them?’ They aren’t broken. 

It’s, ‘How do we fix what’s happening around them to help them feel so they can feel safe enough to be brave enough?’

How can we make the environment feel safer? Sensory accommodations? Relational safety?

Or if the environment is as safe as we can make it, how can we show them that we believe so much in their safety and their capability, that they can rest in that certainty? 

They can feel anxious, and do brave. 

We want them to listen to their anxiety, check things out, but don’t always let their anxiety take the lead.

Sometimes it’s spot on. And sometimes it isn’t. Whole living is about being able to tell the difference. 

As long as they are safe, let them know you believe them, and that you believe IN them. ‘I know this feels big and I know you can handle this. We’ll do this together.’♥️
Research has shown us, without a doubt, that a sense of belonging is one of the most important contributors to wellbeing and success at school. 

Yet for too many children, that sense of belonging is dependent on success and wellbeing. The belonging has to come first, then the rest will follow.

Rather than, ‘What’s wrong with them?’, how might things be different for so many kids if we shift to, ‘What needs to happen to let them know we want them here?’❤️
There is a quiet strength in making space for the duality of being human. It's how we honour the vastness of who we are, and expand who we can be. 

So much of our stuckness, and our children's stuckness, comes from needing to silence the parts of us that don't fit with who we 'should' be. Or from believing that the thought or feeling showing up the loudest is the only truth. 

We believe their anxiety, because their brave is softer - there, but softer.
We believe our 'not enoughness', because our 'everything to everyone all the time' has been stretched to threadbare for a while.
We feel scared so we lose faith in our strength.

One of our loving roles as parents is to show our children how to make space for their own contradictions, not to fight them, or believe the thought or feeling that is showing up the biggest. Honour that thought or feeling, and make space for the 'and'.

Because we can be strong and fragile all at once.
Certain and undone.
Anxious and brave.
Tender and fierce.
Joyful and lonely.
We can love who we are and miss who we were.

When we make space for 'Yes, and ...' we gently hold our contradictions in one hand, and let go of the need to fight them. This is how we make loving space for wholeness, in us and in our children. 

We validate what is real while making space for what is possible.
All feelings are important. What’s also important is the story - the ‘why’ - we put to those feelings. 

When our children are distressed, anxious, in fight or flight, we’ll feel it. We’re meant to. It’s one of the ways we keep them safe. Our brains tell us they’re in danger and our bodies organise to fight for them or flee with them.

When there is an actual threat, this is a perfect response. But when the anxiety is in response to something important, brave, new, hard, that instinct to fight for them or flee with them might not be so helpful.

When you can, take a moment to be clear about the ‘why’. Are they in danger or

Ask, ‘Do I feel like this because they’re in danger, or because they’re doing something hard, brave, new, important?’ 

‘Is this a time for me to keep them safe (fight for them or flee with them) or is this a time for me to help them be brave?’

‘What am I protecting them from -  danger or an opportunity to show them they can do hard things?’

Then make space for ‘and’, ‘I want to protect them AND they are safe.’

‘I want to protect them from anxiety AND anxiety is unavoidable - I can take care of them through it.’

‘This is so hard AND they can do hard things. So can I.’

Sometimes you’ll need to protect them, and sometimes you need to show them how much you believe in them. Anxiety can make it hard to tell the difference, which is why they need us.♥️
The only way through anxiety is straight through the middle. This is because the part of the brain responsible for anxiety - the amygdala - is one of the most primitive parts of the brain, and it only learns through experience.

The goal is for kids to recognise that they can feel anxious and do brave. They don't have to wait for their anxiety to disappear, and they don't need to disappear themselves, or avoid the things that matter to them, in order to feel safe. 

There is always going to be anxiety. Think about the last time you did something brave, or hard, or new, or something that was important to you. How did you feel just before it? Maybe stressed? Nervous? Terrified? Overwhelmed? All of these are different words for the experience of anxiety. Most likely you didn't avoid those things. Most likely, you moved with the anxiety towards those brave, hard, things.

This is what courage feels like. It feels trembly, and uncertain, and small. Courage isn't about outcome. It's about process. It's about handling the discomfort of anxiety enough as we move towards the wanted thing. It's about moving our feet forward while everything inside is trembling. 

To support them through anxiety, Honour the feeling, and make space for the brave. 'I know how big this is for you, and I know you can do this. I'm here for you. We'll do this together.' 

We want our kiddos to know that anxiety doesn't mean there is something wrong with them, or that something bad is about to happen - even though it will feel that way. 

Most often, anxiety is a sign that they are about to do something brave or important. With the amygdala being the ancient little pony that it is, it won't hear us when we tell our kiddos that they can do hard things. We need to show them. 

The 'showing' doesn't have to happen all at once. We can do it little by little - like getting into cold water, one little step at a time, until the amygdala feels safe. 

It doesn't matter how long this takes, or how small the steps are. What matters is that they feel supported and cared for as they take the steps, and that the steps are forward.❤️

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