MS and the mind-body connection

We talk about the mind and body as if they are two separate things, but actually the two are inextricably linked. Almost everything our body does is controlled or moderated by input from the brain and spinal cord, aka the central nervous system (CNS). In fact, this high level of interaction enabled important survival mechanisms that helped us succeed as a species in many different environments and situations – for example it enabled us to be excellent hunter-gatherers in prehistoric times¹.

The ‘flight or fight’ reflex

When the brain senses danger it triggers the adrenal glands (which sit at the top of the kidneys) to release the stress hormones adrenaline and cortisol. This triggers a number of physiological changes designed to ready the body for action: breathing and heart rate increase, blood pressure rises, blood flow to the brain and limbs increases, blood sugar rises rapidly, and the digestive system slows and stomach acidity increases. While this ‘fight or flight’ reflex was crucial to our ancestors’ survival, in modern times it can work against us².

The problem is the brain can’t tell the difference between a real physical danger, such as being chased by a tiger, and an imagined fear, such as worrying about how you’re going to pay this month’s credit card bill; the stress response is the same. That jittery feeling and churning stomach you experience is the fight or flight reflex gearing into action. Which is why stress can cause serious problems for your health in the long term³. Elevated levels of cortisol can actually dampen down the immune system putting you at increased risk of colds and other infections, while adrenaline raises blood pressure, and puts stress on the cardiovascular system. In other words, our psychological state can have a huge impact on our physical health⁴.

The mind–body connection

Scientists have long been aware of the link between mind and body when it comes to illness and a number of studies have since demonstrated how the mind can influence the immune system. One study, for example, in which blood samples were taken from medical students prior and during exam week, showed the students had lower levels of T-cells (cells which attack and destroy invading bacteria) when they were stressed⁵.

But if our mind can make symptoms worse, can it also make them better? Well, the so-called placebo effect is the perfect example of this. To test how effective a drug is, researchers usually divide subjects into two groups – one is treated with the drug and the other receives a placebo that looks like the drug, but contains no active ingredients. Interestingly, studies into some diseases show that some people treated with placebo can experience an improvement in their health. Bizarrely, this can even occur in circumstances where they are aware that they are taking a placebo. The reasons for this are not fully understood and could be due to a number of other factors related to the clinical trial process, such as increased attention from the doctor. But none of this would have come as a surprise to Hippocrates – who more than 2000 years ago noted, ‘The natural healing force within each one of us is the greatest force in getting well⁶.

Adopting a healthy attitude

Living with a challenging condition like Multiple Sclerosis (MS) definitely brings its fair share of stress and anxiety. While it’s understandable that you might feel worried at times, all evidence points to the fact that maintaining a positive mental state can be beneficial to your health⁷.

Meditation  is a great example of this and has been shown to bring a number of health benefits by reducing anxiety and lowering blood pressure. Whether you attend a meditation class, download one of the increasingly popular phone apps, such as ‘Headspace’, take up forest bathing,  or just spend ten minutes every morning quietly focusing on your breathing and clearing your mind, it could make a huge difference to your mental and physical health⁸.

Cognitive behavioral therapy, a form of counselling that helps us to challenge unhelpful thoughts and develop better coping strategies, is another helpful tool for managing stress and anxiety, and is increasingly being used alongside medical treatments for a number of long term health conditions such as chronic fatigue. Perhaps the most helpful strategy of all is simply talking about your feelings⁹. Remember that study of stressed out medical students? The researchers found that immune responses were weakest in the students who reported feeling most lonely¹⁰. In other words, spending time with friends and loved ones could be the best medicine of all.

Healthy body, healthy mind… even healthier body

It’s clear that our mental state can affect our body, but it actually works both ways. While the physical benefits of exercise have long been recognized, increasing evidence suggests that exercise can improve your mental state too. Sure, heading to the pool or lacing up your trainers for a brisk walk might be the last thing you feel like doing when you’re tired and anxious, but most doctors would prescribe it. Firstly, exercise is a wonderful antidote to stress. Think back to those stress hormones we talked about – the ones that help you to deal with danger. Exercise is a great way of stopping cortisol and adrenaline rising too high, and improves the body’s resting heart rate and oxygen uptake¹¹.

There’s also the fact that exercise triggers the brain to produce feel-good chemicals called endorphins that give you a natural high. In fact a review of 30 trials comparing exercise with antidepressants, counselling (such as cognitive behavioral therapy) and placebos concluded that exercise can provide a similar effect to treating the symptoms of mild depression. Endorphins have also been shown to strengthen the immune system and reduce perception of pain – how’s that for a triple whammy?

Regular exercise also helps you to feel more in control of your body; an inner confidence that will empower you to take other challenges in your stride. Which means you might be less likely to get stressed out by the things that don’t matter – and more resilient when it comes to coping with the things that do. Good news for your happiness levels… and your health. Oh, how far we’ve come!

References:

1. Website ‘Encyclopedia.com’ Central Nervous System. Available at: https://www.encyclopedia.com/medicine/anatomy-and-physiology/anatomy-and-physiology/central-nervous-system
2. Website ‘Harvard Health Publishing: Harvard Medical School’ Understanding the stress response. Available at: https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
3. Website ‘MS Trust’ Fatigue. Available at: https://www.mstrust.org.uk/a-z/fatigue
4. Website ‘The Atlantic’ How Stress Makes You Sick. Available at: https://www.theatlantic.com/health/archive/2015/10/how-stress-makes-you-sick/412699/
5. Helané Wahbeh, N.D. Ashley Haywood, N.D. Karen Kaufman, Ph.D., L.Ac. Et al. Mind-Body Medicine and Immune System Outcomes: A Systematic Review (2009) 1: 25–34. doi:10.2174/1876391X00901010025. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516431/pdf/nihms371487.pdf
6. Fabrizio Benedetti, Elisa Carlino  and Antonella Pollo. How Placebos Change the Patient’s Brain. (2011) 36, 339–354. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055515/pdf/npp201081a.pdf
7. Website ‘MS Trust’ Stress. Available at: https://www.mstrust.org.uk/a-z/stress
8. Website ‘MS Trust’ Meditation. Available at: https://www.mstrust.org.uk/a-z/meditation
9. Website ‘NHS.uk’ Cognitive behavioural therapy. Available at: https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/
10. Website ‘Harvard University’ Promoting public health: Loneliness: an epidemic? Available at: http://sitn.hms.harvard.edu/flash/2018/loneliness-an-epidemic/

11. Mental health foundation. Let’s get physical. Mental health awareness week 2013. Available at: https://www.mentalhealth.org.uk/sites/default/files/lets-get-physical-report.pdf