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 shows up to check that you’re okay, not to tell you that you’re not. It’s your brain’s way of saying, ‘Not sure - there might be some trouble here, but there might not be, but just in case you should be ready for it if it comes, which it might not – but just in case you’d better be ready to run or fight – but it might be totally fine.’ Brains can be so confusing sometimes! 

You have a brain that is strong, healthy and hardworking. It’s magnificent and it’s doing a brilliant job of doing exactly what brains are meant to do – keep you alive. 

Your brain is fabulous, but it needs you to be the boss. Here’s how. When you feel anxious, ask yourself two questions:

- ‘Do I feel like this because I’m in danger or because there’s something brave or important I need to do?’

- Then, ‘Is this a time for me to be safe (sometimes it might be) or is this a time for me to be brave?

And remember, you will always have ‘brave’ in you, and anxiety doesn’t change that a bit.♥️

#positiveparenting #mindfulparenting #parenting #childanxiety #heywarrior #heywarriorbook
The temptation to fix their big feelings can be seismic. Often this is connected to needing to ease our own discomfort at their discomfort, which is so very normal.

Big feelings in them are meant to raise (sometimes big) feelings in us. This is all a healthy part of the attachment system. It happens to mobilise us to respond to their distress, or to protect them if their distress is in response to danger.

Emotion is energy in motion. We don’t want to bury it, stop it, smother it, and we don’t need to fix it. What we need to do is make a safe passage for it to move through them. 

Think of emotion like a river. Our job is to hold the ground strong and steady at the banks so the river can move safely, without bursting the banks.

However hard that river is racing, they need to know we can be with the river (the emotion), be with them, and handle it. This might feel or look like you aren’t doing anything, but actually it’s everything.

The safety that comes from you being the strong, steady presence that can lovingly contain their big feelings will let the emotional energy move through them and bring the brain back to calm.

Eventually, when they have lots of experience of us doing this with them, they will learn to do it for themselves, but that will take time and experience. The experience happens every time you hold them steady through their feelings. 

This doesn’t mean ignoring big behaviour. For them, this can feel too much like bursting through the banks, which won’t feel safe. Sometimes you might need to recall the boundary and let them know where the edges are, while at the same time letting them see that you can handle the big of the feeling. Its about loving and leading all at once. ‘It’s okay to be angry. It’s not okay to use those words at me.’

Ultimately, big feelings are a call for support. Sometimes support looks like breathing and being with. Sometimes it looks like showing them you can hold the boundary, even when they feel like they’re about to burst through it. And if they’re using spicy words to get us to back off, it might look like respecting their need for space but staying in reaching distance, ‘Ok, I’m right here whenever you need.’♥️
We all need certain things to feel safe enough to put ourselves into the world. Kids with anxiety have magic in them, every one of them, but until they have a felt sense of safety, it will often stay hidden.

‘Safety’ isn’t about what is actually safe or not, but about what they feel. At school, they might have the safest, most loving teacher in the safest, most loving school. This doesn’t mean they will feel enough relational safety straight away that will make it easier for them to do hard things. They can still do those hard things, but those things are going to feel bigger for a while. This is where they’ll need us and their other anchor adult to be patient, gentle, and persistent.

Children aren’t meant to feel safe with and take the lead from every adult. It’s not the adult’s role that makes the difference, but their relationship with the child.

Children are no different to us. Just because an adult tells them they’ll be okay, it doesn’t mean they’ll feel it or believe it. What they need is to be given time to actually experience the person as being safe, supportive and ready to catch them.

Relationship is key. The need for safety through relationship isn’t an ‘anxiety thing’. It’s a ‘human thing’. When we feel closer to the people around us, we can rise above the mountains in our way. When we feel someone really caring about us, we’re more likely to open up to their influence
and learn from them.

But we have to be patient. Even for teachers with big hearts and who undertand the importance of attachment relationships, it can take time.

Any adult at school can play an important part in helping a child feel safe – as long as that adult is loving, warm, and willing to do the work to connect with that child. It might be the librarian, the counsellor, the office person, a teacher aide. It doesn’t matter who, as long as it is someone who can be available for that child at dropoff or when feelings get big during the day and do little check-ins along the way.

A teacher, or any important adult can make a lasting difference by asking, ‘How do I build my relationship with this child so s/he trusts me when I say, ‘I’ve got you, and I know you can do this.’♥️
There is a beautiful ‘everythingness’ in all of us. The key to living well is being able to live flexibly and more deliberately between our edges.

So often though, the ‘shoulds’ and ‘should nots’ we inhale in childhood and as we grow, lead us to abandon some of those precious, needed parts of us. ‘Don’t be angry/ selfish/ shy/ rude. She’s not a maths person.’ ‘Don’t argue.’ Ugh.

Let’s make sure our children don’t cancel parts of themselves. They are everything, but not always all at once. They can be anxious and brave. Strong and soft. Angry and calm. Big and small. Generous and self-ish. Some things they will find hard, and they can do hard things. None of these are wrong ways to be. What trips us up is rigidity, and only ever responding from one side of who we can be.

We all have extremes or parts we favour. This is what makes up the beautiful, complex, individuality of us. We don’t need to change this, but the more we can open our children to the possibility in them, the more options they will have in responding to challenges, the everyday, people, and the world. 

We can do this by validating their ‘is’ without needing them to be different for a while in the moment, and also speaking to the other parts of them when we can. 

‘Yes maths is hard, and I know you can do hard things. How can I help?’

‘I can see how anxious you feel. That’s so okay. I also know you have brave in you.’

‘I love your ‘big’ and the way you make us laugh. You light up the room.’ And then at other times: ‘It can be hard being in a room with new people can’t it. It’s okay to be quiet. I could see you taking it all in.’

‘It’s okay to want space from people. Sometimes you just want your things and yourself for yourself, hey. I feel like that sometimes too. I love the way you know when you need this.’ And then at other times, ‘You looked like you loved being with your friends today. I loved watching you share.’

The are everything, but not all at once. Our job is to help them live flexibly and more deliberately between the full range of who they are and who they can be: anxious/brave; kind/self-ish; focussed inward/outward; angry/calm. This will take time, and there is no hurry.♥️

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