- 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.
(soulful keyboard and percussion music)
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.
(soulful keyboard and percussion music)